How is Healthcare Paid For
- Becky Blair-Stevenson
- Nov 19, 2022
- 1 min read
One of the most frequently misunderstood concepts in healthcare is healthcare finances. It is a concept that many nurses are not interested in learning about. However, healthcare is a busines and that business is very intertwined with the clinical side of healthcare. Understanding the financial aspect is essential in patient advocacy. If we are to truly advocate for our patient populations, we need to understand how healthcare finance works. Most nurses and consumers do not comprehend that The Centers for Medicare and Medicaid Services controls all aspects of healthcare finances. CMS controls the standard of covered services for all patients. Insurance providers cannot provide less than what is dictated by CMS, but they can offer more. However, since healthcare is a business, why would any insurance company cover a service that CMS does not require them to do? It is a business and we live in a capitalistic society.
Attached is a PowerPoint that I created to educate my students on the finance of healthcare. It is a 30,000 foot overview, but it help highlight the basics and help nurses understand how healthcare is financed in the US. Please feel free to reach out if you have any questions.
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