Utica College Medicaid & Quality of Hospital Work Systems Discussion

1 A. Please response to both posts in APA Format in 250+ words per post

Between 2009 and 2011, a very small number of people accounted for a large share of medical costs annually, and this small number of people were covered by Medicaid (Friberg, 2020). What can we glean from this information? One could deduce that this means the poorest among us experience the greatest need for healthcare. This should be of great importance to nurses, who strive to promote preventive care and health promotion. In hospitals residing in states that expanded Medicaid in 2012, there was less use of Financial Assistance Policies (FAPs), also known as charity care for patients in hospitals (Goodman et al., 2020). Could this mean that due to the expanded coverage, more patients were getting the care they needed and were able to rely less on emergency room visits for illness? Expanding Medicaid is one way that we can help ensure that more members of society can receive the healthcare they need.

Because we live and work in a state that did not expand Medicaid, in my practice as a RN care coordinator serving the homeless and indigent (all of whom are uninsured) population in Pinellas county, I make it my business to print out the Financial Assistance Policies (FAPs) of local non-profit hospitals for our patients. Often, our primary care patients will try to forego a visit to the emergency room even when clearly needed because they are extremely wary of the medical bills they will incur. As their nurse, I am concerned with their well-being, maintenance of health, and preservation of life, not the bill they will get in the mail. For this reason, I make sure our patients are aware that FAPs exist if they need it because this information is not always made readily available to them. Among FAPs being utilized, not all are standardized regarding eligibility requirements and because of this, there is room for improvement to ensure a more equitable treatment of financially needy patients (Goodman et al., 2020).

When serving patients with little financial means, some issues must be considered that healthcare providers do not usually have to think of. For example, towards the end of the month, a number of our patients’ phones are not working due to using up all of the minutes on their “government phone.” This presents a hardship when trying to schedule tele-health visits and so we try to schedule tele-health visits during the first two weeks of the month. Knowing some of our patients are out of minutes, we continue to try to reach them again with more follow-up calls before deciding that the phone number is no good and deeming the patient non-compliant. Our patients’ unique financial situations force us to be more flexible. Many patients we serve have transportation issues; they either have no vehicle, or they rely on family and friends to take them to the clinic for their appointments. A solution to the transportation issue would be a voucher for public transportation via buses for those that do not have reliable ways to get to their appointments.

To conclude, there are many barriers to receiving equitable health care, but with some flexibility on the part of healthcare providers meeting the patients halfway when their socioeconomic status prevents them from receiving the care they need and the expansion of Medicaid in all states, we can help bridge the divide and serve those among us that are the least fortunate.

References

Friberg, E. E. (2020). Conceptual foundations: The bridge to professional nursing practice. (7^th ed.). Elsevier.

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