Research paperHealthcare finance

Healthcare facility or service that accepts Medicaid DQ

Medicaid pays below cost in most settings. The paper's second half is harder than the first, because the obvious remedy is usually unavailable to the facility you chose.

Editorial process

Last reviewed · August 25, 2026

Written by

Maren Caldwell

MSN, RN, CNE

Medical-surgical nursing, pharmacology and NCLEX preparation

Reviewed by

Dr. Tessa Redmond

DNP, RN, CNE

Evidence-based practice and clinical education

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Interpret the task
Assignment instructions
Deliverables
Proposed outline
Research plan
Reference shortlist
Final review

Discounting is a payment-rate problem, not a discount

Start by being precise about what discounting means here, because the word suggests a negotiated reduction and Medicaid payment is not negotiated by the facility at all. Rates are set administratively by a state within federal rules, they vary widely between states, and in most settings they sit below both commercial rates and the facility's cost of providing the service. The hardship therefore depends on payer mix rather than on Medicaid alone: a facility with a small Medicaid share absorbs the shortfall through commercial revenue, while a safety-net hospital or a clinic in a low-income area has no such offset, which is why the same rate produces very different consequences in different organisations. Choose your facility type deliberately, because it determines everything downstream. Everything after this section depends on that choice, so make it deliberately rather than by default. A safety-net hospital and a suburban ambulatory clinic face the same rate and completely different consequences.

The remedy half is where the paper earns its marks, and the obvious answer is usually closed off. A hospital with an emergency department cannot decline patients, and a facility dependent on disproportionate share or supplemental payments has a further reason not to reduce its Medicaid volume. So the realistic levers are elsewhere: making sure every eligible patient is actually enrolled, since uncompensated care pays worse than Medicaid does; capturing supplemental payment programmes and provider tax arrangements the state operates; improving documentation so acuity is reflected in the payment received; reducing the cost of the care itself, which is the only lever that does not depend on somebody else; and participating in managed care or value-based arrangements where they exist. Say which of these your facility could realistically use and which it could not, because a list that ignores the constraints you established earlier undoes the analysis.

Likely learning objectives

Explain Medicaid payment as an administratively set rate rather than a discount.
Analyse payer mix as the determinant of financial hardship.
Identify why declining Medicaid patients is unavailable to most facilities.
Evaluate remedies against the constraints of the chosen facility type.

Assignment instructions

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Review every instruction before using the planning guidance that follows.

Select a healthcare facility or service that accepts Medicaid. Identify ways that Medicaid discounting can cause hardships on the type of facility that you selected. Write a 700- to 1,050-word paper that explores how Medicaid participation has affected organizational finances and what can be done to reduce any loss incurred. Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes. Healthcare facility or service that accepts Medicaid DQ Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor. The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Healthcare facility or service that accepts Medicaid DQ

What the Medicaid paper requires

01A 700-1,050 word paper.
02Selection of a healthcare facility or service that accepts Medicaid.
03Identification of ways Medicaid discounting causes hardship for that facility type.
04An exploration of how Medicaid participation has affected organisational finances.
05What can be done to reduce any loss incurred.
06Three reputable references.