Reflection Artifact

The undertaking of this course was very essential in the achievement of the nursing competencies essential not only to achieving the degree but also necessary for nursing practice. The course looked into the healthcare sector with deeper focus on finance, reimbursement, and other legislative regulatory processes. It has been understood that the environment of the clinical settings experience issues with roots in policy problems. With this in mind it is clear that the nursing profession has an increasing responsibility and role in the field of health policy sector. The nurses are taking up more leadership roles to create an impact on health policy advocacy, research, analysis, development, implementation, and evaluation. Undertaking this course has helped me to develop skills, knowledge, and other required competencies to tackle the issues in the healthcare sector.

It has been very helpful to undertake the program on advocacy and healthcare policy. It has helped me understand the importance of the legislative process to the field of nursing. The course has helped me to understand the nurse’s influence on health policy. This is essential in enhancing and maintaining the quality of care by allowing one to have the required recourses and opportunities. It has brought to my attention the importance of engaging in active development of the healthcare policies as a way of taking control of the practice. This course has helped shape up my values, professional ethics, advocacy skills, and experiences thereby equipping me better to take up better positions in decision making processes.

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By undertaking this course, I have gained more insights on the role of nurses in the medical field and medical management. I have come to understand that nurses play an integral part in the success of the healthcare system. The role of nurses goes beyond being the caregiver to incorporate other roles of a decision maker, effective communicator, and manager of care. As a decision maker, the nurse and the physician are required to make use of their critical thinking skills in carrying out an evaluation and recognizing the problem at hand, thereby, coming up with an intervention plan to better the condition if the patient. Another important and mostly underestimated role is that of being a patient advocate. This involves protecting the rights of the patient. Through this course, I have gained exposure and an opportunity to analyze the Affordable Care Act (ACA) which is comprised of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. It has helped me gain a better understanding of these acts. The ACA was aimed to help increase the number of individuals covered under the health insurance coverage and bring down healthcare-related costs to both the consumers and the government. The course has helped me gain insight on the impact of the ACA on the health insurance field. The law targeted reaching out to the people who could not purchase the insurance and also the underinsured people with insurance coverage that did not adequately cover them or protect them from high medical expenses. The ACA has had a great impact on the insurance cost of the uninsured.

The analysis of the Affordable Care Act helped me to understand how it aimed to develop better health security by coming up with comprehensive health insurance reforms. These reforms were aimed at expanding the coverage, placing accountability to the insurance companies, bringing down healthcare costs, offering more choices to patients, and improving the quality of care for all American citizens. The course has helped me to understand more deeply how the ACA affects the insurance costs. While the ACA do not develop a national health insurance plan, it creates national standards that determine how the health insurance is to be structured and priced and also puts in place new requirements for individuals and employers. Understanding this law has helped me to understand how it has impacted on the health insurance premiums and the costs of health care insurance. This has been through establishing mechanisms through which individuals can acquire health insurance coverage from participating insurers. The law has also mandated employers for businesses with more than 50 employees to get health insurance for their full-time employees.

This course has been very helpful in developing core competencies essential for functioning as successful healthcare professionals. It has been very relevant to help me understand the elements of quality healthcare. It is essential that every health professional be educated on how to deliver patient-centered care. To offer quality healthcare, I have realized the importance of dealing with an interdisciplinary team focusing on evidence-based practice following the quality improvement approaches and informatics. Offering a patient-centered care involves identifying, respecting and being concerned about the patient’s differences, values, preferences and explicit needs. Accumulation of this knowledge will be essential in helping me to resolve to listen, inform, communicate, and educate patients. It is also essential in adhering to the principles of shared decision making and management. Quality healthcare requires the application of evidence-based practice that involves the integration of the best research with the clinical expertise and patients values. This is essential to bringing out optimum care and engagement in learning and research to derive feasible outcomes.

Another important aspect that I have gained by undertaking this case has been an understanding of the medical coding and billing process.  The medical billing process follows the procedure of registration of the patients, determining the financial responsibility, patient check-in and check-out, evaluating the coding and billing compliance, issuing claims, carrying out payer adjudication, developing patient statements, and finally making a plan for the patients’ payments and collections. It has been important to understand the tools used during medical billing and coding. It has also made clear the laws that govern the healthcare industry and how they affect the medical billing and coding processes. It is very clear that during the process, medical practitioners need to handle the information with confidentiality especially during electronic transmission. The diversified information transmitted electronically includes health plans, the care providers, and the healthcare clearinghouses.

By undergoing this course, I have come to understand that I can play an important role in helping out the vulnerable population acquire more access to quality healthcare. I have realized the impacts of Medicare and Medicaid health insurance programs and how they have impacted on vulnerable populations. The overall result of undertaking this course has not only been essential for attaining by Bachelor of Science in Medical Management but has also deepened my understanding on how healthcare policy affects the general quality of healthcare.

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