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NHS FPX 6008 Assessment 3 Business Case for Change

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    NHS FPX 6008 Assessment 3 Business Case for Change

    Student Name

    Capella University

    NHS-FPX 6008 Economics and Decision Making in Health Care

    Prof. Name


    The Healthcare Economic Challenge and its Potential Ramifications

    The challenge of healthcare economics is a pressing issue affecting individuals, healthcare providers, organizations, and communities at large. The lack of affordable healthcare insurance has far-reaching consequences, impacting lives from individuals to entire communities. It goes beyond escalating healthcare costs and individual financial burdens; it also has significant implications for overall health and productivity (McKinsey, 2022).

    Individually, the absence of proper insurance coverage exposes one to financial strain and limited healthcare service accessibility. For organizations, this could lead to increased healthcare expenses and decreased productivity due to employees missing work for illness or seeking expensive emergency care. Additionally, communities may face the consequences of infectious diseases spreading due to a lack of preventive care, resulting in diminished economic productivity and increased healthcare costs.

    The absence of adequate insurance coverage for individuals can manifest in financial strain and limited healthcare access (Peng & Zhu, 2021). Without insurance, individuals may have to bear the full cost of healthcare services, posing a considerable burden, especially for those requiring ongoing care or dealing with chronic conditions. This may lead individuals to postpone or forgo essential medical care, potentially resulting in more severe health issues down the line (Peng & Zhu, 2021).

    Organizations may bear the brunt of providing healthcare services to the uninsured, incurring substantial costs. This, in turn, could drive up healthcare expenses for organizations and potentially result in higher employee insurance premiums (Karpman et al., 2021).

    The decreased productivity of employees without insurance coverage may lead to increased absenteeism, negatively impacting an organization’s bottom line. The World Health Organization (WHO) emphasizes the undeniable impact of the healthcare economic issue and underscores the urgency to address it for the well-being of society. The WHO suggests that affordable healthcare insurance can enhance access to crucial healthcare services, reduce healthcare costs, and bolster productivity (WHO, 2019). It is imperative to take proactive measures to ensure universal access to affordable healthcare coverage, irrespective of income or social status.

    Feasibility and Cost-Benefit Analysis

    The challenge of affordable healthcare insurance necessitates a thorough consideration of feasibility and cost-benefit analysis.

    Feasibility considerations hinge on various factors such as the prevailing political climate, economic conditions, and resource availability (Illinois Government, 2021). For instance, the Affordable Care Act (ACA) aimed to address this issue by broadening access to healthcare insurance. However, its implementation faced significant political opposition and challenges in some states (Campbell & Shore-Sheppard, 2020).

    In terms of cost-benefit considerations, implementing affordable healthcare insurance demands a substantial investment, but the long-term benefits in terms of reduced healthcare costs and improved health outcomes are noteworthy (King, 2020). Studies show that the ACA’s coverage provisions led to a significant reduction in the annual cost of uncompensated care for uninsured individuals, resulting in potential long-term cost savings by increasing preventive care services (Karpman et al., 2021).

    Mitigating Risks to Financial Security

    To mitigate risks to the financial security of healthcare organizations, three potential strategies are proposed:

    1. Improve cost management: Healthcare organizations can employ strategies such as negotiating lower prices for medical services and supplies, and enhancing efficiency in healthcare delivery to manage costs effectively (Sturmberg & Bircher, 2019).
    2. Diversify revenue streams: Exploring alternative revenue sources, such as grants or partnerships with other healthcare providers, can provide a more stable financial base and reduce dependence on fee-for-service models (Kosala & Heengama, 2019).
    3. Implement risk management strategies: Developing and implementing risk management strategies can help healthcare organizations identify and address potential financial risks, including contingency plans for unforeseen events like pandemics or natural disasters (Auditboard, 2021).

    Evidence-Based Research to Support Strategies

    Evidence-based research and scholarly sources support these proposed strategies. For instance, a study in the Journal of Healthcare Finance highlights how cost management strategies, like supply chain optimization, can enhance financial performance in healthcare organizations (Truong, 2022). Another study in the Journal of Healthcare Management emphasizes how diversifying revenue streams can reduce financial vulnerability and improve sustainability (Carney, 2020). Furthermore, a report by the Agency for Healthcare Research and Quality offers guidance on developing and implementing risk management strategies in healthcare organizations (Sturmberg & Bircher, 2019).

    In conclusion, addressing the economic challenge of accessing affordable healthcare insurance necessitates a careful consideration of feasibility and cost-benefit analysis. While the implementation of affordable healthcare insurance can yield substantial long-term benefits, mitigating financial risks involves improving cost management, diversifying revenue streams, and implementing risk management strategies. Evidence-based research and scholarly sources provide invaluable insights to guide these strategies.

    Affordable Healthcare Insurance Solutions

    Several changes and solutions can be implemented to address the economic challenge of accessing affordable healthcare insurance:

    1. Expanding Medicaid: Expanding Medicaid to cover individuals and families beyond current eligibility criteria can enhance access to healthcare services, reduce costs, and improve health outcomes, particularly for low-income populations (Graves et al., 2020).
    2. Implementing a Public Option: Introducing a public option for healthcare insurance allows individuals to purchase affordable plans through a government-run program. This could potentially increase competition, improve access, and reduce healthcare costs (Rapfogel & Calsyn, 2021).
    3. Addressing Prescription Drug Costs: Tackling the high cost of prescription drugs by implementing measures like price transparency, importing lower-cost drugs, and regulating pharmaceutical companies can lead to significant cost savings and improved access to essential medications (KFF, 2019).

    Implementation of the Provided Solution and Potential Benefits

    Implementing these solutions can bring about substantial benefits for organizations, colleagues, and the community. For organizations, these solutions can reduce healthcare costs, enhance the health and productivity of employees, and promote financial stability. Colleagues and the community, on the other hand, stand to gain improved access to essential healthcare services, reduced financial strain, and overall better health outcomes.

    In conclusion, solutions such as expanding Medicaid, implementing a public option, and addressing prescription drug costs can effectively tackle the economic challenge of accessing affordable healthcare insurance. These solutions have the potential to benefit organizations, colleagues, and the community by reducing healthcare costs, enhancing access to essential healthcare services, and improving overall health outcomes. Evidence-based research and scholarly sources provide valuable insights to guide the successful implementation of these solutions.

    Solutions Addressing Cultural and Ethical Considerations

    Proposing a solution for the economic challenge of accessing affordable healthcare insurance requires careful consideration of cultural sensitivity, ethical principles, and equity within the specific community and healthcare setting.

    Cultural sensitivity is crucial, considering the diversity of healthcare practices and beliefs across different cultures and communities (Georgetown University, 2019). When implementing a public option, for instance, it is vital to ensure that the program is marketed and communicated in a way that is accessible and culturally appropriate to the community it serves.

    Ethical considerations are paramount in any healthcare solution implementation. It is imperative that the proposed solution does not unfairly burden or disadvantage specific groups within the community. For example, when expanding Medicaid, careful thought must be given to how it impacts vulnerable populations, such as those with disabilities or chronic health conditions. Ethical considerations also extend to patient privacy, confidentiality, informed consent, and patient autonomy.

    Ensuring equitable access and cost across all community groups is essential for promoting health equity (Nall, 2020). When implementing a public option, it is crucial to ensure that premiums and deductibles are affordable for low-income families and individuals.

    In conclusion, ensuring that a proposed solution for the economic challenge of accessing affordable healthcare insurance is culturally sensitive, ethical, and equitable within the community and healthcare setting is crucial. This involves considering cultural values and beliefs, meeting ethical standards, and ensuring that access and cost are equitable across all community groups. By doing so, health equity can be promoted, and access to essential healthcare services can be improved for all community members.


    The economic challenge of accessing affordable healthcare insurance is a complex issue with widespread implications for individuals, organizations, and communities. Addressing this challenge requires a comprehensive approach, considering feasibility, cost-benefit analysis, potential benefits, and cultural, ethical, and equitable considerations. By implementing evidence-based strategies and solutions, such as expanding Medicaid, introducing a public option, and addressing prescription drug costs, we can effectively tackle this challenge.

    In conclusion, taking a comprehensive and evidence-based approach to the economic challenge of accessing affordable healthcare insurance can promote health equity and improve access to essential healthcare services for all community members.


    Agency for Healthcare Research and Quality. (2021). Developing and implementing a risk management plan: AHRQ patient safety network.

    Auditboard. (2021, February 18). 10 Types of risk management strategies to follow in 2021.

    Campbell, A. L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of the Affordable Care Act: Introduction to the issue. RSF: The Russell Sage Foundation Journal of the Social Sciences, 6(2), 1–40.

    Carney, K. J. L. (2020). Practitioner application. Journal of healthcare management, 65(1), 71–72.

    Georgetown University. (2019). Cultural competence in health care: Is it important for people with chronic conditions? – Health Policy Institute. Health Policy Institute; GeorgeTown University.

    Graves, J. A., Hatfield, L. A., Blot, W., Keating, N. L., & McWilliams, J. M. (2020). Medicaid expansion slowed rates of health decline for low-income adults in Southern States. Health affairs, 39(1), 67–76.

    NHS FPX 6008 Assessment 3 Business Case for Change

    Illinois Government. (2021). Feasibility report for coverage affordability initiatives in Illinois.

    Karpman, M., Coughlin, T. A., & 2021. (2021, April 6). Declines in uncompensated care costs for the uninsured under the ACA and implications of recent growth in the uninsured rate. KFF.

    KFF. (2019, March 15). KFF Health Tracking Poll – February 2019: Prescription Drugs. The Henry J. Kaiser Family Foundation.

    King, J. S. (2020). Covid-19 and the need for health care reform. New England Journal of Medicine, 382(26).

    Kosala, G., & Heengama, B. (2019). Scholar works revenue diversification to improve and maintain service offerings of nonprofit organizations part of the finance and financial management commons, and the organizational behavior and theory commons. Walden University.

    McKinsey. (2022). Transformative impact of inflation on the healthcare sector | McKinsey.

    NHS FPX 6008 Assessment 3 Business Case for Change

    Nall, R. (2020, September 8). Health equity: Definition, examples, and action.

    Peng, Z., & Zhu, L. (2021). The impacts of health insurance on financial strain for people with chronic diseases. BMC Public Health, 21(1).

    Rapfogel, N., & Calsyn, M. (2021, May 5). Public options will improve health equity across the country. Center for American Progress.

    Sturmberg, J. P., & Bircher, J. (2019). Better and fulfilling healthcare at lower costs: The need to manage health systems as complex adaptive systems. F1000Research, 8, 789.

    Truong, H., Yee, T., & Tu, D. (2022). The impact of cost management strategies on financial performance in healthcare organizations. Journal of Healthcare Finance, 49(2), 1-15.

    WHO. (2019). Economic and social impacts and benefits of health systems report.