Mastering Healthcare Regulation: A Comprehensive Case Study Approach

Overview

Trying to make sense of the regulatory landscape in healthcare can be difficult. The many federal and state entities and their rules may work together, yet they sometimes contradict one another. Mastering Healthcare Regulation will help readers understand and ultimately navigate the numerous layers of regulatory oversight within the healthcare system. This book clarifies laws and regulations with straightforward explanations and case studies that place readers in the shoes of regulatory decision-makers.The first section presents an overview of healthcare regulation, including market dynamics and the interactions between the various regulatory organizations. Each section that follows focuses on a broad subject that regulations seek to address: cost containment; consumer protection; payment and delivery system reform; and patient access, health, and safety. Background is provided on each issue, and real-world scenarios are used to illustrate regulatory approaches and their economic, legal, and clinical ramifications. The book will teach readers how to decipher the regulatory landscape's complexities and how to influence regulations rather than simply being impacted by them.

Author Biography

Robin J. Lunge, JD, MHCDS, serves as one of five members of the Green Mountain Care Board which is responsible for designing and administering healthcare payment and delivery system reform as well as regulating Vermont’s healthcare industry. Lunge previously worked as the director of healthcare reform for Vermont governor Peter Shumlin and as an attorney at the Vermont Legislative Council. Betty Rambur, PhD, RN, FAAN, is a nursing professor and Routhier Endowed Chair for Practice at the University of Rhode Island. She is a recognized leader in the area of workforce redesign within alternative payment models and a fellow of the American Academy of Nursing. In 2020 Dr. Rambur was appointed to the Medicare Payment Advisory Commission by the US Comptroller General. Jessica Holmes, MA, MPhil, PhD, serves as one of five members of the Green Mountain Care Board, which is responsible for designing and administering healthcare payment and delivery system reform as well as regulating Vermont’s healthcare industry. Dr. Holmes is also a professor of economics at Middlebury College, where she received the Gladstone Award and the Marjorie Lamberti Faculty Appreciation Award, both honoring excellence in teaching.