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NURS 8100 Week 5: Economic and Technological Influences on Policy

Economic factors have long been a key driver of health care policy and reform efforts.
As noted in previous weeks, for instance, health policies have attempted to improve the
situation for millions of uninsured or underinsured individuals and to address the
barriers to health care access that have arisen as a result of the high costs associated
with insurance and health service delivery.
This week, you will examine how economics influences health policy and health care
reform efforts. You will explore cost containment strategies from increasing
administrative efficiency to health care rationing and the role of technology in health
care reform and cost control efforts.
Learning Objectives
Students will:
 Evaluate the use of technology to achieve health care reform and cost containment
goals
 Analyze the economic consequences of a health care policy
Photo Credit: [Robert Nicholas]/[OJO Images]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical
approach (7th ed.). New York, NY: McGraw-Hill Medical.
 Chapter 8, “Painful Versus Painless Cost Control”
Chapter 8 focuses on the relationship between health care costs and health
outcomes and its importance on the health policy agenda. This chapter also
presents strategies for effectively utilizing resources as opposed to rationing
health care services.
 Chapter 9, “Mechanisms for Controlling Costs”
Chapter 9 examines an array of policies aimed at controlling health care costs
and reviews specific financial and reimbursement cost containment methods to
health outcomes.
Buntin, M., Jain, S., & Blumenthal, D. (2010). Health information technology: Laying the
infrastructure for national health reform. Health Affairs, 29(6), 1214–1219. doi:
10.1377/hlthaff.2010.0503
Note: You will access this article from the Walden Library databases.
In this article, the authors examine the role of health information technology as a major
component in the restructuring of health care. They suggest it will improve quality,
reduce costs, and allow for seamless access to data across providers.
Margolius, D., & Bodenheimer, T. (2010). Transforming primary care: From past
practice to the practice of the future. Health Affairs, 29(5).
Note: You will access this article from the Walden Library databases.

The authors propose a primary care practice of the future in which physicians act as
leaders of a team of health care professionals. Reimbursement would shift from a pay-
per-service model to a comprehensive model that incorporates both a standardized
payment per patient and performance pay based on improved patient health outcomes.
Maxson, E., Jain, S., McKethan, A., Brammer, C., Buntin, M., Cronin, K., … Blumenthal,
D. (2010). Beacon communities aim to use health information technology to transform
the delivery of care. Health Affairs, 29(9), 1671–1677. doi: 10.1377/hlthaff.2010.0577
Note: You will access this article from the Walden Library databases.
Monheit, A., Cantor, J., DeLia, D., & Belloff, D. (2011). How have state policies to
expand dependent coverage affected the health insurance status of young
adults? Health Services Research, 46(1), 251- 267.
Note: You will access this article from the Walden Library databases.

Young adults (19-29 years of age) are one of the highest uninsured segments of U.S.
population. Some states have mandated extended dependent coverage; however, the
study presented in this article depicts little effect on uninsured rates. The authors
suggest that the PPACA 2010 provision mandating expanded dependent coverage will
have better success because more health plans will be involved in the mandate.
Rosenthal, M., Beckman, H., Forrest, D., Huang, E., Landon, B., & Lewis, S. (2010).
Will the patient-centered medical home improve efficiency and reduce costs for care? A
measurement and research agenda. Medical Care Research & Review, 67(4), 476–484.
Note: You will access this article from the Walden Library databases.

This article discusses the use of Patient-Centered Medical Homes (PCMHs) as a cost
containment strategy. The authors maintain that credible research needs to be
conducted to evaluate the actual results.
Steuerle, C. E., & Bovbjerg, R. R. (2008). Health and budget reform as
handmaidens. Health Affairs, 27(3), 633–644.
Note: You will access this article from the Walden Library databases.
Wilensky, G. (2010). Health economics. Information Knowledge Systems Management,
8, 179–193.
Note: You will access this article from the Walden Library databases.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy:
Cost containment. Baltimore: Author.

Note: The approximate length of this media piece is 13 minutes.

In this media presentation, Dr. Gerald Kominski and Dr. Walter Zelman discuss the
challenges policy makers face in containing health care expenditures and costs.

Accessible player

Discussion: Technology and Cost

Containment

In response to continually rising health care costs, the Health Information Technology
for Economic and Clinical Health (HITECH) provision was created to promote the
meaningful use of health care information technology through numerous incentive
programs for health care providers. By enhancing data collection, streamlining
electronic medical records, and increasing transparency, it is believed that significant
cost savings can be realized as well as other positive outcomes. What are some of the
tradeoffs involved in this type of policy?
To prepare:
 Reflect on the challenges of containing health care costs in the U.S. presented in the
Learning Resources and discussed by Dr. Kominski and Dr. Zelman in the media.
 Consider how information technology may be used to address health care issues
related to cost.
 Examine the Health Information Technology for Economic and Clinical Health (HITECH)
provision and its goals.
By Day 3
Post a cohesive response that addresses the following:
 Briefly summarize a significant challenge to containing health care costs.
 How do policy makers envision technology could be utilized to address this challenge
(above)? Provide at least one example to support your response.
 Do you agree or disagree with the policy makers? Describe why you agree or disagree
and include one or more insights from this analysis that relate to the question of how
information technology could, or could not, help contain costs while supporting health
care reform initiatives.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
 Ask a probing question, substantiated with additional background information, evidence
or research.
 Share an insight from having read your colleagues’ postings, synthesizing the
information to provide new perspectives.
 Offer and support an alternative perspective using readings from the classroom or from
your own research in the Walden Library.
 Validate an idea with your own experience and additional research.
 Make a suggestion based on additional evidence drawn from readings or after
synthesizing multiple postings.

 Expand on your colleagues’ postings by providing additional insights or contrasting
perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question
posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 5 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 5 Discussion

Assignment 1: Issues in Health Care

Reform (Interview)

Continue to work on this Assignment, assigned in Week 2 and due in Week 9.
By Day 7 of Week 9
Submit this Assignment.
Assignment 2: Health Policy Proposal

Analysis (Policy Brief)

Continue to work on this Assignment, assigned in Week 3 and due in Week 7. Consider
the potential economic benefits of the recommendation you have selected and how the
recommendation may contribute to controlling health care costs. Include this information
in your policy brief.
By Day 7 of Week 7
Submit this Assignment.
Assignment 3: Policy Analysis Paper

[Major Assessment 2]

Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze
the financial and economic context of your selected health care policy. Include an

analysis of the costs of the various policy solutions and the primary funding sources.
This information should be included in Part 2 of your analysis paper.
By Day 7 of Week 11
Submit this Assignment.

Week in Review

This week, you evaluated the use of technology to achieve health care reform and cost
containment goals and analyzed the economic consequences of a health care policy.
Next week, you will review the four principles of medical ethics and examine these
principles in the light of current health care policy.
To go to the next week:
Week 6

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