NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States

NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States

NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States

Topic 7 DQ 1

Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States (may be state or federal). What impact do these population health policies and initiatives have on advanced nursing practice?

Re: Topic 7 DQ 1

Health Policies are general statements that have goals at different levels of abstraction and range in scope and serve as a broad guideline to organizations. Public policy is set in to place to implement policies and regulations to govern practices to help the population as a whole and to ensure practices are equitable for all(Tullai-McGuinness, 2017). In my state of Washington there are many health care policies that are set into place to help ensure the health of the population is protected. The WHO in 2003 stated health is a “state of complete physician mental and social wellbeing in the absence e of disease(Tullai-McGuinness, 2017). One policy in Washington state that was set into place is Ricky’s Law that allows the states mental health system to involuntarily detain adults and minors who pose a serious harm to themselves as result of substance abuse disorder(WHSA, 2020) This policy is designed to enable the protection of someone under the influence from having further harm to themselves, while the intention is for any person fitting the criteria to be seen and evaluated, the policy does state if there is not enough room in the ER there is not another option, this creates can create a barrier for many facilities and patients to access the care they need in a crisis.

Washington state is a state with large cities and very rural area, another public health policy in

Washington that is helping to protect the delivery of care in rural areas.  THis policy is designed to help keep hospitals, clinics and health care access in areas of our most vulnerable populations of all cultures especially native American and Hispanic cultures where the majority live. Rural health care in Washington serves about 70% if the states area and 15% of the population (WSHA, 2020a). This policy initiative is designed to engage the communities, provide innovative access and redefining hospitals to adapt the change of health care today.

As advanced practice nurses wether in leadership, education or practicing medicine, these policies are to help guide our practice, to help ensure the population is protected and access is provided to all the population. The role of the  advance practice nurse is to utilize the guidance of the policies, add evidence-based practice and create accessible care for all within the policy guidance.

Tullai-McGuinness, S. (2017). Health Policy and Health Services Delivery. Encyclopedia Of Nursing Research, 251. https://doi.org/https://search-credoreference-com.lopes.idm.oclc.org/content/entry/spennurres/health_policy_and_health_services_delivery/0?institutionId=5865

WHSA. (2020). Information about RIcky’s Law: Involuntary Detention for Substance Use Disorders. Washington State Hospital Association. https://www.wsha.org/policy-advocacy/issues/information-about-rickys-law-involuntary-detention-for-substance-use-disorders/

WSHA. (2020a). Protecting Rural Health Care. Washington State Hospital Association. https://www.wsha.org/policy-advocacy/issues/protecting-rural-health-care/

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RESPOND HERE (150 WORDS, 3 REFERENCES)

Hello Deana,

I agree with you that healthcare policies are set at both the state and federal levels to ensure that the healthcare guidelines are streamlined to promote access to quality care. Politicians at houses of representatives and congress work through the committee to ensure that they formulate policies that are relevant to the emerging healthcare needs and challenges. One such example in the state of Washington is the Ricky Law of Involuntary Treatment Act (ITA). In 2018, the proposed changes on the law took effect. The changes were; designated mental health professionals are to also work in the capacity of designated crisis responders (DCRs) (Saya et al., 2019). Additionally, community members who are a danger to themselves, others or property or disabled as a result of alcohol or substance abuse maybe involuntarily detained to what is referred to as a secure detox. The members of the community under this detention program are under protection of the patients’ rights as outlined in the Rights of Involuntarily detained persons. It is a requirement that these rights be displayed prominently in all facilities providing the secure detox services (Dey et al., 2019).

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NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States References

Dey, S., Mellsop, G., Diesfeld, K., Dharmawardene, V., Mendis, S., Chaudhuri, S., Deb, A., Huq, N., Ahmed, H. U., Shuaib, M., & Khan, F. R. (2019). Comparing legislation for involuntary admission and treatment of mental illness in four South Asian countries. International Journal of Mental Health Systems, 13(1). https://doi.org/10.1186/s13033-019-0322-7

Saya, A., Brugnoli, C., Piazzi, G., Liberato, D., Di Ciaccia, G., Niolu, C., & Siracusano, A. (2019). Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00271KELLI

Re: Topic 7 DQ 1

The Affordable Care Act (ACA) has shifted our focus in health care delivery from a fee for service base to more of a quality of care

focus. In the specialty of oncology, the Centers for Medicare and Medicaid Services (CMS) has created the Oncology Care Model (OCM). The goal of OCM is to financially incentivize high quality oncology care (Centers for Medicare and Medicaid Services [CMS], 2021). The practice where I work, participates in the OCM, and every year we are audited by CMS where they look at certain criteria in the patient’s charts. For example, one criterion they have a focus on is oral oncolytic adherence protocols. We have to show documentation in the patient’s chart that we are monitoring the patient’s adherence to their oral medications. If our practice meets the guidelines set by OCM, then we are awarded financially. On the other hand, if we do not meet the guidelines, we can actually be penalized financially as well. This encourages the practice as a whole to implement policies and procedures to ensure the best quality of care is being provided to our patients.

Another policy implemented by the ACA with a focus on health equity, is prohibiting insurance companies to use pre-existing conditions as a way to deny an individual to health insurance or impose waiting periods for coverage (Facing Our Risk of Cancer Empowered [FORCE], 2021). This also plays a huge role in the oncology field. Often times, patients diagnosed with cancer may lose their job because of their inability to continue working due to treatment schedule or adverse events. These patients will then need to find other health insurance policies since they may lose their work insurance. Previously, health insurance companies would be able to deny coverage for their cancer therapies since they were previously diagnosed with cancer prior to starting the insurance policy. The ACA will ensure equity in care for all individuals whether or not they have been diagnosed with a chronic or serious illnesses.

Population groups that experience the most profound healthcare disparities are the ones that can most benefit from the full and unrestricted use of nurse practitioners (NPs) as primary care providers. As a result of the decreased numbers of physicians choosing primary care as their specialty in favor of better-paid specialties, there is a shortage of primary care providers, especially in areas of higher ethnic and racial diversity (Poghosyan & Carthon, 2017). Nurse practitioners are an ideal solution to this problem. With the increased numbers of nurse practitioners now practicing, one would think that the problem would solve itself. However, varying healthcare policies governing the ability of nurse practitioners to provide primary care as well as reimbursement disparities have hampered this ready-made solution. One problem limiting the successful implementation of nurse practitioners are the varying and inconsistent scope of practice guidelines between states. These inconsistencies affect aspects of practice such as the ability of NPs to prescribe medications, practice independently without the oversight of a physician and the ability to admit patients to the hospital. Another issue impacting NPs ability to meet the primary care shortage is the inconsistency in billing practices and reimbursement. Some insurance companies recognize NPs as primary care providers as reimburse them for care and others do not. Medicare reimburses NPs at 85% of what they reimburse MDs for providing the same care. These factors lead to NPs being drawn to practice in regions that allow for full practice and better reimbursement. Unfortunately, this situation exacerbates the shortage of NPs providing primary care in underserved areas.

NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States References:

Poghosyan, L. & Carthon, J. (2017). The untapped potential of the nurse practitioner workforce in reducing health disparities. Policy, Politics, & Nursing Practice, 18(2):84-94. doi:10.1177/1527154417721189

The US healthcare system has been facing various challenges limiting it from meeting the desired objective. Its complexity caused the federal government to allocate its highest budget each year (Spurlock, 2020). However, various policies tend to affect the US system. The two major policy issues affecting healthcare delivery and population health are the shortage of nurses and medication errors. These policy issues directly affect health as they define the quality of healthcare delivery.

            Nurse shortage has been an issue in the US, where the ratio of nurses to patients is low. For instance, a single nurse has to attend to many patients, which results in fatigue. The healthcare ministry has been at the forefront of solving this issue by increasing the number of nurses within the healthcare system (Drennan & Ross, 2019). Issues of nurse shortage have been discussed at length in the US, allowing the healthcare ministry to welcome the opinions of healthcare professionals in designing policies that would solve the issue. However, the increase in the number of patients has been making such efforts futile, as the ratio seems unfair for the nurses.  

            Medication errors are another policy issue that affects the quality of healthcare delivery. These errors result in a complicated issue as healthcare organizations fail to meet the desired patient outcome. Strengthening policies on technology and the use of Medical health records have been important in addressing the problem (Stehman et al., 2019). EHRs systems have been significant in eliminating manual recording of patient treatment and resulted in collaboration among professionals that further result in the success of quality care. Besides, the systems allow interconnectedness among healthcare organizations where no patient information can be lost or mismanaged by a single person. Such advancements have been significant in addressing medication errors and ensuring that healthcare professionals work towards meeting the desired patient outcome.

NUR 550 Topic 7 DQ 1 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States References

Drennan, V. M., & Ross, F. (2019). Global nurse shortages: The facts, the impact and action for change. British Medical Bulletin, 130(1), 25-37. https://eprints.kingston.ac.uk/id/eprint/43086/6/Drennan-V-43086-AAM.pdf

Spurlock Jr, D. (2020). The nursing shortage and the future of nursing education is in our hands. Journal of Nursing Education, 59(6), 303-304. https://doi.org/10.3928/01484834-20200520-01

Stehman, C. R., Testo, Z., Gershaw, R. S., & Kellogg, A. R. (2019). Burnout, drop out, suicide: Physician loss in emergency medicine, part I. Western Journal of Emergency Medicine, 20(3), 485. https://doi.org/10.5811%2Fwestjem.2019.4.40970