Discuss the mission of the Patient-Centered Outcomes Research Institute (PCORI) and the Center for Medicare & Medicaid Innovation (CMMI).

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Community Nursing – Discussion QuestionsReview the attached PowerPoints presentations. Once done answer the following questions:1. Do you feel it is better to allow individuals the freedom to choose any type of  (or no) health insurance coverage available to them or to increase government involvement in a person’s/family’s healthcare via mandates, such as the ACA and/or the government as a single insurer for all residents.  Why?2. Discuss the mission of the Patient-Centered Outcomes Research Institute (PCORI) and the Center for Medicare & Medicaid Innovation (CMMI).ORDER A PLAGIARISM-FREE PAPER NOW3.If you could reform the malpractice or tort laws, what types of changes would you make? When do you feel it is appropriate for someone to claim damages from medical procedures or treatment? Do you feel there should be a cap on the payments, and if so, how would you decide what that cap would be? What are all the different costs involved in medical malpractice suites? Is it easier to talk about tort reform than to actually try to define it?4.  The rights of people once they have been incarcerated can be a controversial topic of discussion. Discuss the healthcare rights of the incarcerated population. What do you feel should or should not be provided to those who are imprisoned? Are there certain tests or procedures that they feel should be performed routinely? Why or why not? What is the nurse’s role, based on the section on page 248?– APA format word document, Arial 12 font.– A minimum of 3 evidence-based references no older than 5 years  (excluding the class textbook) are required.– A minimum of 600 words are required (excluding first and last page).From now on discussion questions will have a rubric.Community Nursing – Discussion QuestionsChapter 8Economics of Health CareEconomic Approach to Health CareCompetition in the market–Healthcare market–Demand–Supply–CompetitionCompetition Versus RegulationStandards of participationCost containment and valueMarket Failure in Health CareFree market competitionMarket failureSupplier-influenced demandThird-party payerImperfect marketRising Costs and Today’s Healthcare SystemSocial Security Act of 19351959 Federal Employees Health Benefit Act and Blue Cross1960’s Medicaid (Title XIX) and Medicare (Title XVIII)Increased costs–Gross domestic product (GDP)Rising Costs and Today’s Healthcare System (cont.)Decreased access–Rising costs/inability to pay–Increased number of people covered by Medicare and Medicaid; decreased number covered by private insurance–More employers offering insurance; fewer employees are purchasing it–Private insurance does not guarantee financial access to care–Public programs offer inadequate prenatal and mental health care programs–Negative outcomes for the uninsured/underinsured–Rising Costs and Today’s Healthcare System (cont.)Influences on costs and access–Increased sources of funds from governments–Inflation–Drug cost increase–Advanced technology is expensive–Higher personnel wages and benefits costs–Change in population demographics–Excess–Medical excess–Administrative excess–Emphasis on cure instead of preventionPaying for Health CareOut-of-pocket payments and charity–Cost sharingHealth insurance–Private insurance–Employment-based insuranceExperience ratingCommunity rating–Health insurance purchasing cooperatives–Self-insurancePaying for Health Care (cont.)Publicly funded insurance and direct care programs–MedicarePart A–Inpatient hospital care»Benefit period–Skilled nursing facility–Home health agency–HospicePart B and Part DMedicare Advantage“Medigap” insurancePaying for Health Care (cont.)–MedicaidEntitlement/welfare programBased on income and assetsCategorically needyMedically needyPersonal Responsibility and Work Opportunity Act–Temporary Assistance for Needy Families (TANF)Paying for Health Care (cont.)–Children’s Health Insurance Program (CHIP)Federally funded–CHAMPUS–Other public direct care programs:Public Health Service Act of 1994Affordable Care Act (ACA) of 2010Cost Containment, Cost Analysis, and QualityCost-containment strategies–Controlling quantity of supply–Controlling price–Controlling quantity of demand–Competition–Prioritizing through cost analysisCost Containment, Cost Analysis, and Quality (cont.)Cost analysis–Cost-of-illness analysis–Cost–benefit analysis–Cost-effectiveness analysis–Technology assessmentPublic Health, Managed Care, and the Economics of PreventionOpportunities for collaboration–Cost-containment efforts–Shift from acute services to preventiveCounterforces to collaboration–Safety net–Dumping of services–Coordination of state reporting–Nature of for-profit firmsEconomics of alternative therapiesSignificance of Economics for Community Health Nursing PracticeDisease prevention/health promotionConsumer-driven health careNurses can help consumers understand price and quality issuesGaining third-party reimbursement—an important labor market change for nursesCoalition building, research, lobbying, negotiating with insurers, influencing policymakingEconomics and Nightingale’s LegacyMarket justiceSocial justiceCommunity Nursing – Discussion QuestionsChapter 13Environmental HealthTrends in Exposure and DiseaseWorld view–Health risks from environmental toxicants–Rapid increase in the world’s population–Changes in urbanization and agricultural production–Recent ecological changesPopulation movementDeforestationIrrigationExpanding urbanizationChange in agricultural practicesEnvironmental HealthDefinition: freedom from illness or injury related to toxic agents and other environmental conditions–Applications range from hospital rooms to international and global perspectives on health of the planetEnvironmental Health Policy: Historical PerspectivesEarly environmental health focused on sanitation, water quality, and housing–Mortality rates decreasedInfluential publication:–Carson, R. (1962). Silent spring. Boston: Houghton MifflinLegislation and commissions–Clean air and water acts–Occupational health–Safety acts–Pollution Prevention Act of 1990–Toxic Substances Control Act–Environmental Protection Agency–Occupational Safety and Health Administration Nuclear Regulation Commission–Recent Health Issues & TrendsIssues–Damage to the environment–Population growth–Urban spread–Advanced technology–Industrialization–Modern agricultural methodsTrends–Focus on the built environment–Children’s environmental healthChemicals, pesticides, mercury, smoke–Environmental justice movementHistorical Perspectives on Environment and HealthEpidemiology–Time–Person–PlaceChronic disease epidemiology–Asbestos and mesothelioma–Prenatal exposure to diethylstilbestrol (DES)–Occupational exposureOrigins of Environmental Health PolicyIndustrial Revolution—1800s–Focus on modernization and rapid production of goods and services–Growing concern for working conditions and safety of workers1900s–Environmental health and safety–Passages of laws to protect the public–Pure Food and Drug Law–Food and Drug Administration1960s–1970s–Post-war industrial rebuilding–Consumer-driven environmental movementEnvironmental Policy: Governmental RolesProtect and safeguardPass laws and enact rules and regulationsIdentify and monitor risks and hazards–Healthy People 2020Monitor compliance with rulesGather data to inform policymakersNursing and the EnvironmentNightingale–Pure, fresh air–Pure water–Efficient drainage–Cleanliness–LightEmerging Role–Intervene directly in environmental factors–Role of the Community Health NurseIdentify risksAssess exposuresCommunicate risksAssess and refer clients“Upstream Thinking”Ethical Principles–Social justice–Environmental justiceCommunity Nursing – Discussion QuestionsChapter 9Politics and the LawGovernment AuthorityProtection of the public’s health–U.S. Constitution–Bill of Rights–State powerPower, Authority, and theHealth of the PublicConcepts of power–Coercive–Reward–Expert–Legitimate–Referent–Information–ConnectionEvolution of the Government’sRole in Health CarePreamble of the U.S Constitution–“Promote the general welfare” of the peopleMarine Hospital ServiceThe Shattuck ReportHill-Burton ActEvolution of the Government’sRole in Health Care (cont.)Medicare & MedicaidThe Civil Rights Act of 1964National Environmental Policy ActAmericans with Disabilities Act (ADA)Affordable Care Act (ACA) of 2010Federal Government1.Executive–Office of the President2.Legislative–Congress3.Judicial–Federal Court SystemU.S. Public Health AgenciesNational Institutes of HealthFood and Drug AdministrationCenters for Disease Control and PreventionIndian Health ServiceHealth Resources and Services AdministrationSubstance Abuse and Mental Health Services AdministrationAgency for Healthcare Research and QualityU.S. Public Health Service CorpsHuman Services AgenciesCenters for Medicare and Medicaid ServicesAdministration for Children and FamiliesAdministration on AgingDepartment of EducationDepartment of LaborLegislative BranchU.S. Congress–Has two houses with equal power:SenateHouse of RepresentativesJudicial Branch94 federal districts courts12 circuit courts of appealsU.S. Supreme CourtSeveral specialized courtsState GovernmentExecutiveLegislativeJudicialLocal GovernmentPublic healthPublic educationDrinking waterSewage disposalPolice protectionSolid waste managementDifferent Types of LawConstitutional lawStatutory lawJudicial or common law–Civil or criminalRegulation of Nursing PracticeNurse practice acts of each state control:–Requirements for entry into practice–Standards for acceptable practice–Standards for continuing competence–Disciplinary actionsBoard of NursingLicensure of Nursing PracticeNational Council Licensing Examination for Registered Nurses (NCLEX-RN)Nursing Practice and LawNegligence and malpracticeCorrectional settingsForensic nursingChapter9   Chapter13   Chapter81Community Nursing – Discussion Questions Do you need a similar assignment done for you from scratch? 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