Nursing Policies Assignment Paper

Nursing Policies Assignment Paper

Nursing Policies Assignment Paper

First Page

One important feature of the U.S. healthcare system is the high healthcare costs. The U.S has the highest annual per capita health expenditures globally and had an average of $11,172 in 2018. Besides, the health care costs have increased between 4.2 and 5.8% annually over the past five years (Nunn et al., 2020). One thing that has attracted my interest is that the US spends more than other high-income countries without having better health outcomes. Health care expenditure is escalating as a share of the economy and government budgets in a fashion that seems unsustainable (Nunn et al., 2020). Spending on health care has increased progressively, rising from $2,900 per individual in 1980 to $11,200 in 2018, a 290% increase.

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High healthcare costs are significant in terms of health policy and reform since policies and reforms are needed to reduce the spending in various healthcare sectors. For instance, hospital care takes about a third of all healthcare spending, while professional services account for approximately a quarter of spending (Nunn et al., 2020). In addition, long-term care, nursing care facilities, and home health care take 13%, prescription drugs take 9%, and net health insurance costs account for 7%.

One of the conditions related to enacting the PPACA is the individual mandate, which requires citizens to purchase healthcare coverage or risk a tax penalty. Most consumers with no employer-sponsored coverage have limited choice but to purchase the higher-cost plans through the health insurance exchanges (Gluck & Scott-Railton, 2019). However, a majority of young adults chose to take the tax penalty. The individual mandate was the most legally and politically controversial aspect of PPACA and was challenged in the Supreme Court. The court renounced the claim that the individual mandate was within Congress’s commerce power, and the mandate was found to be constitutional as a tax. Before that, 26 states had challenged PPACA constitutionality in lower courts, and it has been the most contested bill in modern American history (Gluck & Scott-Railton, 2019). The numerous court challenges to proposed reforms explain why health reform in the U.S has been so difficult.

References

Gluck, A. R., & Scott-Railton, T. (2019). Affordable Care Act Entrenchment. Geo. LJ, 108, 495.

Nunn, R., Parsons, J., & Shambaugh, J. (2020). A dozen facts about the economics of the US healthcare system. Economic Facts. Washington, DC: The Hamilton Project.

Page Two

Accountable Care Organizations (ACOs) are networks of healthcare providers who team up to provide improved and cost-effective treatment interventions to healthcare consumers. ACOs were established under the Medicare Shared Savings Program, a section of the PPACA of 2010 (Lewis et al., 2018). ACOs are associated with potential positive outcomes and unexpected consequences. An example of a positive result is cost-effective healthcare services. Cost-effective care can be achieved through the ACA incentive matrix, which was established to counteract the trend of health costs rising irrationally with the traditional Medicare fee-for-service model (Wilson et al., 2020). Therefore, ACOs have the potential to decrease healthcare costs since ACO providers are usually designated against a series of quantitative benchmarks. Furthermore, it can promote significant healthcare savings and maximize Medicare incentives if they meet the CMS agreements (Wilson et al., 2020).

ACO providers may experience unintended consequences with the ACOs, like feeling that they are trapped in an unfavorable network. Lewis et al. (2018) explain that ACOs are designed to reduce this consequence by eliminating structural barriers to the HMO system. Nonetheless, various healthcare economists have conveyed concerns that consolidation by ACOs may limit options available to healthcare consumers. Another unintended consequence for organizations is financial losses since ACOs share losses if they fail to decrease the cost of healthcare (Lewis et al., 2018). Organizations may face penalties if they do not meet quality and cost savings benchmarks.

The current organization I work in should consider the economic losses related to ACOs, which may occur if it does not meet the objective of lowering healthcare costs. Thus, if the organization fails to reduce costs, there may not be enough return on investment (ROI) to improve healthcare delivery in the facility. In addition, the nursing profession should consider ACO issues like the requirement on ACO providers to meet certain quality benchmarks on prevention and effectively managing individuals with chronic diseases. Therefore, nurse professionals who decide to participate in an ACO must bear in mind that they must provide high-quality preventive care and management interventions for patients with chronic conditions.

References

Lewis, V. A., D’Aunno, T., Murray, G. F., Shortell, S. M., & Colla, C. H. (2018). The Hidden Roles That Management Partners Play In Accountable Care Organizations. Health affairs (Project Hope), 37(2), 292–298. https://doi.org/10.1377/hlthaff.2017.1025

Wilson, M., Guta, A., Waddell, K., Lavis, J., Reid, R., & Evans, C. (2020). The impacts of accountable care organizations on patient experience, health outcomes, and costs: a rapid review. Journal of Health Services Research & Policy, 25(2), 130–138. https://doi.org/10.1177/1355819620913141

Page Three

The nursing shortage is one of the clinical practice issues that I wish to see on my organization’s systematic agenda. The organization has faced an acute nursing shortage in the past three years, attributed to low retention rates due to a high nursing turnover and a retirement of nurses in the baby-boomers generation without an adequate replacement. The nursing shortage has led to unsafe nurse-patient ratios, increased workload for nurses, nurse fatigue and burnout, and compromised quality of care attributed to missed nursing care and preventable medical errors (Shah et al., 2021).

The gap between the increasing healthcare demands from clients and the supply of nurses to respond adequately to these needs has become more obvious with the COVID-19 pandemic. Therefore, there is a crucial need for the organization’s leadership to identify sustainable ways to address the nursing shortage and lower the nursing turnover to ensure the delivery of high-quality nursing care and promote better patient outcomes (Shah et al., 2021).

Support from stakeholders is fundamental in addressing any clinical issue to promote the successful execution of proposed interventions. Therefore, it is crucial to engage both internal and external stakeholders from the beginning and at every stage when solving the clinical issue for their continuance support (Kim et al., 2018). Strategies that would be used to inform and persuade stakeholders of the importance of addressing the nursing shortage include organizing face-to-face individual and group meetings. During these meetings, I would present actual statistical data on the nursing shortage, including the turnover rate in the past years and the prevalence of medical errors associated with a high nursing workload. The data would be important in persuading them to take necessary interventions to correct the issue. Communication would also be through e-mails, telephone calls, and writing formal letters.

References

Kim, K. K., Khodyakov, D., Marie, K., Taras, H., Meeker, D., Campos, H. O., & Ohno-Machado, L. (2018). A novel stakeholder engagement approach for patient-centered outcomes research. Medical care, 56(10 Suppl 1), S41. https://doi.org/10.1097/MLR.0000000000000790

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA network open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469

Page Four

The Affordable Care Act (ACA) is an example of a healthcare policy in the US that seeks to improve access to healthcare by increasing the number of citizens with healthcare insurance. A policy analysis framework helps identify and understand the relationship between important variables relevant to the policy issue. The primary concern of policy analysis is the health policy outcomes or the policy’s impact on individuals (Masselink et al., 2021). The fact that a health concern requires an intervention shows that the existing health policy is ineffective. Thus, alternatives should be examined through policy analysis to address the health problem.

I would use Bardach’s framework to analyze the ACA. I selected it because it provides step-by-step guidance for policy analysis and is valuable for professionals with limited time, resources, and experience in policy analysis studies. Besides, Bardach’s framework does not need sophisticated analysis methods since it focuses on the policy issue and can be used to accomplish the goal of policy analysis over a short time (Engelman et al., 2019). The framework comprises eight steps: Define the problem; Search and assemble evidence; Consider different policy options; Select the criteria; Predict the outcomes; Use evaluative criteria to confront trade-offs; Make the decision; Disseminate the results of the process (Engelman et al., 2019).

The Bardach framework offers an approach to address the common limitation in policy analysis of having insufficient data to support changes in practice, even though an important policy question has been identified. A policy analysis framework might also guide in analyzing the policy process and content (Masselink et al., 2021). It can be used to analyze policy formulation and the substance of policy. Policy content analysis explores a significant policy issue and the options to address this issue.

References

Engelman, A., Case, B., Meeks, L., & Fetters, M. D. (2019). Conducting health policy analysis in primary care research: turning clinical ideas into action. Family Medicine and Community Health, 7(2). http://dx.doi.org/10.1136/fmch-2018-000076

Masselink, C. E., LaBerge, N., & Detterbeck, A. (2021). Policy analysis on power standing systems. Preventive Medicine Reports, 24, 101601. https://doi.org/10.1016/j.pmedr.2021.101601

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PLEASE USE 2-3 REFERENCES FOR EACH PAGE ALL IN the LATEST APA STYLE AND FORMATE
ALL REFERENCES MUST BE WITHIN THE PAST 5 YEARS. YOU MAY REPEAT SOME REFERENCES BUT NOT THE SAME FOR EACH PAGE. MIX REFERENCES UP.
Discussion

FIRST PAGE

Analyze at least one important feature of the U.S. health care system that is of particular interest to you. Explain why you think this feature is significant in terms of health policy and reform.
• Describe one or more conditions or challenges specifically related to the passing of the PPACA. Explain how this exemplifies the nature of the policy-making process, and evaluate how it could relate to the question of why health reform in the United States has been so difficult.

PAGE TWO
You may choose topic

Identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience. • Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession.

PAGE THREE- you can choose any issue
• Identify the clinical practice issue you would like to see on your organization’s systematic agenda. • What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue.

PAGE 4
Identify the policy you have selected. • Describe the framework that you would use for this particular issue, and provide your rationale. • At what other stages in the policy process might an analysis framework provide guidance?