** There are 2 Topics, they both require 3 references. 

Discussion Topic 1: Cost Shifting  

Identify health care policies that use cost shifting. Argue the benefits of cost shifting. How might the Affordable Care Act decrease cost shifting within hospitals?

APA Style, minimum of 200 words, times new romans, font 12, No plegearism  3 References, scholarly.

Discussion Topic 2: Managed Care 

In what way does managed care actually manage cost? 

Does it do so without diminishing the quality of care? If so, how does it accomplish this?

APA Style, minimum of 200 words, times new romans, font 12, No plegearism

3 References, scholarly.

Daniel is a 16 year old boy who is an identical twin. He and his brother Jeff are very close and do most things together. While Daniel excels at sports he believe his brother is much better at most everything. Daniel, his brother, and their two sisters live with their parents in the Midwest. Recently Daniel has been feeling more tired than usual. He thought it was because of his schedule and school work, which he is fairly good at. He gets mostly Bs, but his grades have been slipping of late. One day he fainted while getting ready for a game. His coach called his parents to let them know Daniel was taken to the Emergency Room. While there the doctor decided to admit Daniel to the hospital for observation. At the time he was running a slight fever, his breathing was shallow, and he was sweating. He was also very sleepy and his blood pressure was high. He did have some abnormal laboratory work, but his doctor was not too concerned at present. Daniel also stated that he felt achy.

You are assigned to take care of Daniel today and when you walk into his room, his mother and brother Jeff are there. Daniel appears to be sleeping. In your written assignment, respond to the following questions applying the nursing process:

Assessment: What type of objective and subjective data can you collect with what you know? How will you collect these data? What further evidence do you need?

Analysis and Identification of the Problem: What do you believe Daniel’s problem(s) are? What might be the nursing diagnoses? Use the following for identification.

Planning: Identify two goals and one nursing intervention for each, based on your nursing diagnoses.

While you will not be able to implement or evaluate, how well do you think your nursing interventions might help with Daniel’s care.

Accelerating retirement of registered nurses in US.

Foundational Accounting Concepts   

Although it is important to be familiar with foundational accounting concepts and to understand how they are calculated, it is equally important to recognize how the information from these calculations fits into the larger picture of daily actions in hospitals. Consider the simple task of taking patients their dinner trays. Think of all of the different costs that are involved. The dietitian must be paid, as well as the food handlers. The food has to be purchased as well as the trays and utensils. Trays must be delivered, picked up, and cleaned. A cost is incurred at each stage.  In this Discussion, you consider how the costs of the daily tasks performed by nurses are accounted for and impact cash flow.  

To prepare: •Review this week’s Learning Resources focusing on the difference between accrual accounting and cash accounting. Conduct additional research as needed until you are confident that you grasp the distinction between the two approaches. 

•Consider why you would select one approach over the other and the effect it would have on financial decision making. Determine how you could explain these concepts to someone not familiar with accounting. 

•Select a task you might perform daily, or an item that you might use daily in the workplace, and determine where the cost should appear on a balance sheet. 

•Reflect on the role of cash in the financial operations of an organization. How could cash flow issues impact your own organization (or one with which you are familiar)?  

 Post an explanation of the difference between accrual accounting and cash accounting, and when each might be used. Then, describe a task you might perform or an item you might use daily, and explain where the cost should appear on a balance sheet, and why. Finally, assess how cash flow issues could impact your own organization (or one with which you are familiar).

Required Readings  

Baker, J. J., Baker, R. W., & Dworkin, N. R.  (2018). Health care finance: Basic  tools for nonfinancial managers (5th ed.). Burlington, MA: Jones and  Bartlett Learning.  

•Chapter 4, “Assets, Liabilities, and Net Worth” (pp. 33-36)    In this chapter, you are introduced to the meaning of assets, liabilities, and net worth. You explore the relationship between the three and how they must be balanced if an organization is to be successful.     •Chapter 6, “Expenses (Outflows)” (pp. 47-54)    The focus of this chapter is expenses and how they differ from costs. It highlights how costs should be reported and how expenses can be grouped for more effective planning and control.     •Chapter 9, “Understanding Inventory and Depreciation Concepts” (pp. 81-93)    This chapter examines the relationship between inventory and the cost of goods. It demonstrates how to calculate inventory turnover and product depreciation.     •Chapter 11, “Reporting as a Tool” (pp. 119-125)    This chapter describes the basic financial reports and how they are used in financial decision making. The four key financial statements are the balance sheet, the statement of revenue, and expense, the statement of fund balance or net worth, and the statement of cash flows.      

Zelman, W., McCue, M., & Glick, N. (2009). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications (3rd ed.). Hoboken, NJ: Jossey-Bass.  Retrieved from the Walden Library databases. 

 •Chapter 2, “Health Care Financial Statements” (pp. 25–86)    This chapter describes the shared four basic financial statements of all organizations. The authors relate the basics to business-oriented and non-for-profit health organizations.     

•Chapter 3, “Principles and Practices of Health Care Accounting” (pp. 87–120)    This chapter explores the accounting practices and principles of health care. The authors detail the rules for recording transactions and the process of recording and developing financial statements.