Policy and Advocacy Essay

Assignment: Assessing a Healthcare Program/Policy Evaluation Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives. Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy. To Prepare: Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources. Select an existing healthcare program or policy evaluation or choose one of interest to you. Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described. The Assignment: (2–3 pages) Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following: Describe the healthcare program or policy outcomes. How was the success of the program or policy measured? Policy and Advocacy Essay. How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? At what point in program implementation was the program or policy evaluation conducted? What data was used to conduct the program or policy evaluation? What specific information on unintended consequences was identified? What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. Did the program or policy meet the original intent and objectives? Why or why not? Would you recommend implementing this program or policy in your place of work? Why or why not? Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation. By Day 7 of Week 10 Submit your completed healthcare program/policy evaluation analysis. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name. Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open. If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Click on the Submit button to complete your submission. Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

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Medicare

From the beginning of 2019, the Medicare program started covering specific health services provided through asynchronous telehealth technologies.

Description

Medicare is a federal/state medical insurance program that covers healthcare for older adults in the US, and some individuals with disabilities. Medicare includes two sections for hospital and health insurance (Part A and Part B), and two other sections that provide prescription drugs and flexibility (Part C and Part D). Policy and Advocacy Essay.

Measuring the Success of the Program

The health of older adults has significantly improved since the implementation of Medicare, as measured by functional status and longevity. Additionally, in comparison to individuals with private medical insurance, individuals enrolled in Medicare have greater access to healthcare and experience lesser problems with medical bills (Seo et al., 2019). This is very significant because Americans in Medicare are likely to have low income and suffer from poor health. Before Medicare, approximately half of Americans older adults did not have medical insurance, while over 25% did not access medical care because of high healthcare costs. Currently, almost all older adults can access affordable healthcare.

People were Reached by the Program and Impact

Medicare has played a major role in providing financial and health security to approximately 60 million older adults and young individuals with disabilities. The program helps individuals to pay for health care services, consisting of admissions, prescription medications, physician visits, preventive services, hospice care, and home health care (Roy et al., 2018).

Impact of the Program

Medicare has played a major role in protecting individuals against medical expenditure risk (Barcellos & Jacobson, 2015). Specifically, Medicare program has improved access to healthcare and improved the health status of a high number of people because currently can access care due to improved affordability.

Basically, Medicaid provides comprehensive health coverage and financial protection for millions of citizens in the US. In spite of the low income, people enrolled in Medicaid have better access to care than individuals with private coverage. Additionally, Medicaid covers expensive long-term care for many older adults and individuals of all ages who have disabilities. Moreover, Medicaid supports Medicare by assisting Medicare beneficiaries who are low-income earners pay premiums and provide long-term services, in addition to supporting services not covered by Medicare (Burd et al., 2017).

Evaluation of the Program Implementation

The Centers for Medicare and Medicaid Services (CMS) evaluates the Medicaid program. Every year, CMS collects data from all states on Medicaid, analyses the data, generates research reports, and works on the reports to eliminate any abuse or fraud in the healthcare system (Chee et al., 2016). States submit the data every month to CMS.

Data used to Conduct the Program Evaluation

The data used to evaluate the Medicaid program include enrollment activity and eligibility. This data indicates various indicators allied to eligibility, key application, as well as enrollment procedures in the state Medicaid. CMS releases the data to the public through a sequence of monthly reports via the Medicaid Performance Indicator Project. Policy and Advocacy Essay.

Specific Information on Unintended Consequences

Evaluations have shown that Medicaid reimbursements are low and this leads to decreased revenue. Therefore, healthcare organizations and healthcare providers who have a large patient base of Medicaid beneficiaries tend to have lesser profits. Moreover, evaluations have shown that Medicaid has increased waiting times during medical appointments (Goldman & Sommers, 2020).

Stakeholders identified in the Evaluation of the Program

The main stakeholders in the Medicaid program include senior adults and people with disabilities. The beneficiaries of the Medicaid program would benefit the most from the evaluation results. For example, an evaluation could identify areas that need improvement to improve access to care and also reduce waiting times for patients during appointments. Healthcare organizations and healthcare providers also benefit from evaluations because evaluations may indicate the health aspects that Medicaid needs to increase reimbursement rates.

Whether the Program Met the Original Intent and Objectives

The program met the key objectives and the original intent. This is because the Medicaid federal/state program was intended to increase health insurance coverage for senior adults and people with disabilities to improve healthcare access. As intended, almost all older adults within the US have health insurance coverage and their access to healthcare services has significantly improved.

Recommending the Implementation of the Program

Medicaid program is recommendable in my workplace. This is because low-income workers with disabilities can significantly benefit from the Medicaid program. Low-income workers do not have private insurance and thus may be unable to access high-quality healthcare services (Burd et al., 2017). Therefore, enrolling all low-income earners with disabilities in the Medicaid program can go a long way in improving their access to high-quality care.

Role of the Nurse Advocate in Evaluating the Program

During the program’s evaluation, the nurse has the role of researching to locate and retrieve the latest evidence and collect data relevant to the evaluation process. Therefore, during the evaluation, the nurse has the role to collect the latest and best evidence to inform any changes that may be necessary. Moreover, the data can be used to examine the impact of the program and identify any weaknesses in the program, and thus facilitate the implementation of the appropriate improvements (Sastre-Fullana et al., 2017). During the evaluation, the nurse also has the role to disseminate the findings from evaluations to different stakeholders and audiences with the interest to help in improving the program, based on the evaluation’s findings. Basing on the findings, the nurse has the role of influencing and persuading the relevant managers of the program to implement the recommendations from the evaluation.

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General Comments

Medicare health coverage has positively impacted the lives of Americans, improved life expectancy, improved access to care, and improved the health of Americans. Policy and Advocacy Essay.  However, even though evaluations indicate that the Medicare program has exclusively achieved the intended objectives to improve healthcare access, there have been a few identified unintended consequences. For example, evaluations have demonstrated that Medicaid has lower reimbursements for healthcare organizations and healthcare providers, which may affect their profitability. Overall, since its implementation, Medicare has had positive impacts by improving access to care and affordability of healthcare services among older adults and people with disabilities.

References

Barcellos, S. H., & Jacobson, M. (2015). The Effects of Medicare on Medical Expenditure Risk and Financial Strain. American economic journal. Economic policy, 7(4), 41–70.

Burd, C., Brown, N. C., Puri, P., & Sanghavi, D. (2017). A Centers for Medicare & Medicaid Services lens toward value-based preventive care and population health. Public Health Reports, 132(1), 6-10

Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current State of Value-Based Purchasing Programs. Circulation, 133(22), 2197–2205. https://doi.org/10.1161/CIRCULATIONAHA.115.010268

Goldman, A. & Sommers M. (2020). Among low-income adults enrolled in Medicaid, churning decreased after the Affordable Care Act. Health Affairs, 39(1), 85–93.

Seo, V., Baggett, T. P., Thorndike, A. N., Hull, P., Hsu, J., Newhouse, J. P., & Fung, V. (2019). Access to care among Medicaid and uninsured patients in community health centers after the Affordable Care Act. BMC health services research, 19(1), 291.

Roy, N., Dubé, R., Després, C., Freitas, A., & Légaré, F. (2018). Choosing between staying at home or moving: A systematic review of factors influencing housing decisions among frail older adults. PloS one, 13(1), e0189266. https://doi.org/10.1371/journal.pone.0189266

Sastre-Fullana, P., Morales-Asencio, J. M., Sesé-Abad, A., Bennasar-Veny, M., Fernández-Domínguez, J. C., & De Pedro-Gómez, J. (2017). Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation. BMJ open, 7(2), e013659. https://doi.org/10.1136/bmjopen-2016-013659. Policy and Advocacy Essay .