NUR 550 Topic 8: Using Research to Support Health Policy, Advocacy, and Policy Development

NUR 550 Topic 8: Using Research to Support Health Policy, Advocacy, and Policy Development

NUR 550 Topic 8: Using Research to Support Health Policy, Advocacy, and Policy Development

Description

Objectives:

1. Discuss the role of translational research in advancing equitable access to health care and prevention services and policies based on population
2. Evaluate the role of the advanced practice nurse in advocating for equitable population health services and

Benchmark – Diverse Population Health Policy Analysis

Select a current or proposed health care policy that is designed to provide equitable health care for a diverse population. Create a 12-15-slide PowerPoint presentation discussing the health care policy and how it improves a specific population’s access to quality, cost-effective health care. Create speaker notes of 100-250 words for each slide. Include additional slides for the title and references.

Include the following in your presentation:

1. Describe the policy
2. Discuss the diverse population that will be affected by this
3. Explain how the policy is designed to improve cost-effectiveness and health care equity for the diverse
4. Discuss why the policy is financially sound and explain how the policy incorporates the nursing perspective and relevant ethical, legal, and political Provide rationale to support your explanation.
5. Describe what state, federal, global health policies, or goals the policy is related to and explain the degree to which each helps achieve equitable health care for the diverse
6. Discuss advocacy strategies for improving access, quality, and cost-effective health care for the diverse population
7. Discuss the professional and moral obligation of master’s prepared nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian

You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark – Diverse Population Health Policy Analysis Sample Presentation Notes

Introductions

Hello, and welcome to today’s presentation. My name is _, and the focus is on equitable population health. Population health equity is the just and fair opportunity for the population to attain their maximum health. The state is achieved by developing favorable policies in care delivery to promote better patient outcomes. Healthcare policies are integral in promoting equitable health in the population. Equitable population health leads to a healthier population hence a decreased need for healthcare and better population outcomes. Most policies target vulnerable populations and prevent individual exploitation by ensuring quality, safe, and accessible care. The policy of interest is the Affordable Care Act, which emphasizes the Medicaid expansion policy, affecting coverage eligibility criteria. The target population/population of interest is low-income families with or without multiple health needs.

Affordable Care Act Policy

The ACA Medicaid expansion policy provisions were developed at the national level. Still, the states were free to opt in or out and alter the policy implementation base on the social determinants of health in the respective states. The new expansion focuses on improving access to Medicaid by enhancing eligibility through income level-low-income does not hinder quality healthcare access. Individuals whose income level is up to 138% of the federal poverty level qualify for Medicaid expansion (Peikes et al., 2020). Peikes et al. (2020) note that other priorities included lifting the 65-year barrier and increasing access to comprehensive health premiums. Individuals below age 65 without children and whose income meets the new eligibility criteria have access to Medicaid. 

ACA Medicaid Expansion Policy

Besides qualification based on income level, individuals with chronic untreated conditions such as diabetes, hypertension, and heart disease also qualify for Medicaid coverage. Individuals with chronic illnesses have difficulty securing market premiums due to hardships and high costs of market premiums for individuals with chronic illnesses. Peikes et al. (2020) state that eligibility varies by state, and individuals in non-expansion states meeting the new criteria still do not have access to insurance coverage. The Medicaid beneficiaries were not affected. Some 12 million individuals whose market premiums did not meet the new set standards were forced to get new premiums to improve quality care access. ACA not only improved Medicaid eligibility but also enhanced the policies of those with non-comprehensive insurance coverage (Peikes et al., 2020).

The Policy Design on Cost-effectiveness and Healthcare Equity

Medicaid pays insurance premiums for its beneficiaries, reducing the insurance burden while ensuring they access quality healthcare services. Brooks et al. (2020) show that policy allows states to cost-share with a targeted group of individuals through cost-sharing avenues such as out-of-pocket costs that may include co-payments, coinsurance, deductibles, and other similar charges. These groups include Medicaid beneficiaries whose income is 150% FPL and above or whose eligibility is based on their medical needs. Brooks et al. (2020) note that cost-sharing also applies to prescription drugs, where they pay up to 20% of the cost of these medications. These payments help strike a balance for the beneficiaries to access care services. Through these arrangements, all populations can access services while ensuring individuals access quality care while ensuring individuals with the ability to contribute to funds do so.

Policy Financial Soundness

The policy is based on the premise that individuals from low-income families cannot afford market insurance premiums, and insurance cover affects health-seeking behavior and population health outcomes. Before the expansion, individuals had limited access to insurance premiums. A coverage gap existed between individuals whose income was too low to afford market premiums and too high to qualify for Medicaid. The federal government will be responsible for fund reimbursement for Medicaid expansion. The government will provide 100% reimbursement for expansion states for the first three years and then 90/10% cost sharing with state governments for the subsequent years (Brooks et al., 2020). The benefits and reimbursement plans of the policy make it financially sound and sustainable, despite the fears of many states that the plan is unsustainable.

ACA and Nursing Perspective

Cleveland et al. (2019) note that ACA reforms share nursing perspectives of caring and quality care delivery, staff support, and access to healthcare services. The current ACA reforms focus on ensuring individuals have access to insurance coverage. According to Duggan et al. (2018), increased insurance coverage rates increase access and utilization of healthcare services. The policy provision will help reduce hospital readmissions, a vital nursing goal. Individuals will also have access to quality care and hence quality lives, as is the goal of nursing care: to improve the quality of life. Tanden (2020) states that ACA has revived closing facilities, especially in rural areas, and improved healthcare services delivery in others, increasing access to care and equitable population health.

ACA and Ethical, Legal, and Political Factors

 ACA promotes health equity by eliminating healthcare discrimination and reducing health disparities among ethnic and racial minority groups. Brooks et al. (2020) note that the policy enactments from 2014 prevented public and private insurance agencies from discriminating against people based on pre-existing conditions. The act also factors political and social factors, allowing state delegation and perspectives on Medicaid expansion. Some federal policies are mandatory based on their intended purposes, while some are left to states to determine their implementation. The policy also allows states to implement cost-sharing at their discretion to certain limits to enhance equitable care. In addition, the recently developed policy protects patients and prevents states from making the eligibility criteria for Medicaid stricter during Covid-19. The act will also give employees the mandate to give employees sick leave to enhance their ability to support their families as they access and utilize healthcare services.

State, Federal, and Global health policies or goals related to Medicaid Expansion

The ACA interacts with other policies, national strategies, and goals to improve care delivery and promote equitable access to vulnerable populations (Soni et al., 2020). The ACA is a broad act that interacts back and forth with many acts, including drug pricing policies and the Children’s Health Insurance Program. It also interacts with and impacts national goals and strategies such as Healthy People 2030 and the President’s National HIV/AIDS strategy. The interactions improve ACA scope and enhance better patient outcomes in healthcare facilities. They also produce superimposed effects by ensuring the relevance, significance, and acceptance of ACA and these policies. 

ACA and Drug Pricing Policies

ACA plays a huge role in managing drug pricing. Conti et al. (2020) note that the Centers for Medicaid and Medicare, in collaboration with ACA, regulate drug pricing by setting standards for their insured drugs. The ACA sets a price for their insured drugs to ensure manufacturers lower prices, consequently lowering the drug prices to the public (Conti et al., 2020). However, states such as Illinois and California have varying drug pricing policies derived from the ACA and CMS recommendations. ACA reforms such as 340B prescription drug discount programs lower generic drug prices and helps states regulate their drug prices. ACA thus plays a huge role in implementing state drug pricing policies.

Healthy People 2030

Healthy People 2030 is the national strategy to improve population health outcomes by 2030. The national strategy entails goals and their specific objectives with attached indicators that show the current steps and efforts and the status of the objective. A major goal of the Healthy People 2030 strategy in the “Health care access and quality” is to Increase access to comprehensive, high-quality healthcare services” (Healthy People 2030.gov, n.d.). Two major objectives of the goal are to increase the proportion of insured individuals and the prescription drug rate and reduce the number of uninsured individuals under 65 (Healthy People 2030). ACA Medicaid expansion policies are the greatest pioneer in the growth and expansion of insurance coverage and thus play a role in achieving the objectives and goal of Healthy People 2030.

Children’s Health Insurance Program

The ACA and CHIP have long interacted in various instances to improve children’s coverage and promote better health for the children population. Hudson et al. (2018) note that CHIP provides insurance to children through Medicaid CHIP programs depending on the child’s parents’ eligibility for Medicaid. CHIP covers over 5 million children, and the ACA improves CHIP capacity through uniform parent income definition to determine eligibility. ACA policy provisions also facilitated the transfer of all children whose parents meet the new Medicaid eligibility criteria of 138% FPL to Medicaid insurance coverage, relieving the burden off CHIP (Hudson et al., 2018). ACA’s move to improve adult inclusion in Medicaid also improved children’s access to coverage. ACA also holds outreaches to increase population knowledge, and utilization of the insurance plans have also improved children’s coverage, relieving the burden on chip and improving utilization of chip and Medicaid services.

President’s National HIV/AIDS Strategy

HIV/AIDS patients have trouble accessing private health insurance coverage and are vulnerable to insurance industry abuses/bias. Kay et al. (2018) note that most private insurance companies refuse to insure them and cap insurance benefits for HIV/AIDS patients they insure. ACA and The President’s HIV/AIDS strategy combine efforts to curb the disparity and ensure these patients have access to full insurance benefits and equal access to healthcare services. Kay et al. (2018) note that the ACA lifted various limitations, such as capping insurance health benefits to a certain limit by the private insurance institutions to ensure all individuals have equitable access to healthcare services benefits. The ACA, through Medicare part D reforms, ensures fair drug pricing hence access to affordable HIV/Aids medications. The ACA thus improved the President’s HIV/AIDS strategy by increasing patients’ insurance coverage and benefits and minimizing the economic burden accompanying an HIV/AIDS diagnosis.

Advocacy Strategies for Improving Access, Quality, and Cost-effective Healthcare for the Diverse Population Selected

Nurses can employ various advocacy strategies to improve access to quality, cost-effective healthcare in the vulnerable population. Patient education and communication with patient families increase their knowledge of available policies that can help improve their care access. Uninsured patients in the facility can be directed to the policy through extensive education. Cleveland et al. (2019) note that some institutions have policies that require all nurses to educate patients about policies such as ACA and other policies depending on the patient’s needs. Nurses also assist patients with application and access processes to ensure the utilization of these resources and the implementation of learned knowledge. 

Master’s Prepared Nurses Moral and Professionals Obligation

Benedet et al. (2018) show that advanced practice registered nurses have advanced knowledge and skills in nursing practice and should utilize them to improve patient outcomes and care quality. Their care quality should be distinguished, and they should lead healthcare teams toward achieving quality care delivery is patient safety. APRNs perspectives in policy development are vital for healthcare services advancement. Playing roles in developing, proposing, and evaluating policies is an overarching role that assists them in providing dignified care to patient populations according to the Christian worldview. Cleveland et al. (2019) note that APRNs should also be at the frontline, allowed limited or full independent practice, and use the privileged to improve care outcomes in underserved communities where their services are most needed. 

Conclusion

ACA is a healthcare policy that increases access to low-income families and individuals affected by chronic illnesses. The population (low-income families) suffers from limited access to healthcare services and generally poor patient outcomes. The policy provisions increase access to healthcare services for this vulnerable population and thus pioneer equitable population health.

References

Béland, D., Rocco, P., & Waddan, A. (2019). Policy feedback and the politics of the Affordable Care Act. Policy Studies Journal, 47(2), 395-422. https://doi.org/10.1111/psj.12286

Benedet, S. A., Padilha, M. I., Gelbke, F. L., & Bellaguarda, M. L. D. R. (2018). The model professionalism in the implementation of the Nursing Process (1979-2004). Revista Brasileira de Enfermagem, 71, 1907-1914. https://doi.org/10.1590/0034-7167-2017-0226

Brooks, T., Roygardner, L., Artiga, S., Pham, O., & Dolan, R. (2019). Medicaid and CHIP eligibility, enrollment, and cost sharing policies as of January 2019: Findings from a 50-state survey. San Francisco: Kaiser Family Foundation. Accessed January, 22, 2020.

Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care: an examination of how the insurance coverage expansions of the Affordable Care Act have affected disparities related to race and ethnicity. Health Affairs, 39(3), 395-402. https://doi.org/10.1377/hlthaff.2019.01394

Center for Disease Control and Prevention (CDC), (2020). The Affordable Care Act Helps People Living with HIV/AIDS. HIV. Retrieved December 6, 2022, from https://www.cdc.gov/hiv/policies/aca.html

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of nurses. Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man02

Conti, R., Dusetzina, S. B., & Sachs, R. (2020). How The ACA Reframed The Prescription Drug Market And Set The Stage For Current Reform Efforts: A look back at the ACA’s successes and missed opportunities at improving prescription drug affordability. Health Affairs, 39(3), 445-452. https://doi.org/10.1377/hlthaff.2019.01432

Duggan, M., Goda, G. S., & Jackson, E. (2019). The effects of the Affordable Care Act on health insurance coverage and labor market outcomes. National Tax Journal, 72(2), 261-322. https://doi.org/10.1086/713496

Goldman, A. L., Woolhandler, S., Himmelstein, D. U., Bor, D. H., & McCormick, D. (2018). Out-of-pocket spending and premium contributions after implementation of the Affordable Care Act. JAMA internal medicine, 178(3), 347-355. https://doi.org/10.1001/jamainternmed.2017.8060

Healthy People 2030.gov (n.d.). Health Care Access and Quality. Overview and Objectives. US Department of Health and Human Services. Retrieved December 6, 2022, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality

Hudson, J. L., & Moriya, A. S. (2018). Association between marketplace policy and public coverage among Medicaid or Children’s Health Insurance Program–eligible children and parents. JAMA pediatrics, 172(9), 881-882. https://doi.org/10.1001/jamapediatrics.2018.1497

Kay, E. S., Batey, D. S., & Mugavero, M. J. (2018). The ryan white HIV/AIDS program: supplementary service provision post-affordable care act. AIDS Patient Care and STDs, 32(7), 265-271. https://doi.org/10.1089/apc.2018.0032 

Peikes, D., Taylor, E. F., O’Malley, A. S., & Rich, E. C. (2020). The Changing Landscape Of Primary Care: Effects Of The ACA And Other Efforts Over The Past Decade: A description of primary care delivery system reform models developed and tested over the past decade by the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act. Health Affairs, 39(3), 421-428. https://doi.org/10.1377/hlthaff.2019.01430

Soni, A., Wherry, L. R., & Simon, K. I. (2020). How Have ACA Insurance Expansions Affected Health Outcomes? Findings From The Literature: A literature review of the Affordable Care Act’s effects on health outcomes for non-elderly adults. Health Affairs, 39(3), 371-378. https://doi.org/10.1377/hlthaff.2019.01436

Tanden, N. (2020). Revival and Resilience. Horizons: Journal of International Relations and Sustainable Development, (17), 174-189.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

• : Examine financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political

• : Determine advocacy strategies for improving access, quality, and cost-effective health care for diverse

• : Integrate appropriate state, federal, and global health policies and goals into the design of equitable health care for

• : Examine the professional and moral obligation of master’s-prepared nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian. GCU NUR-550 Translational Research and Population Health Management

Topic 8 DQ 1

Description:

Discuss the role of translational research in advancing equitable access to health care and preventative services and policies based on population health. Provide an example of a local health care policy that has been recently enacted and or is awaiting legislative passage that has been influenced by research.

NUR550 Topic 8 DQ1 Using Research To Support Health Policy, Advocacy, And Policy Development

As seen in previous stages, translational research plays a vital role. Translational research is divided into stages that help healthcare professionals understand population needs and plan for their management. Resource allocation, a major issue of equitable access to care, can be improved by the results of translational research. Populations are affected by different social determinants of health, and understanding and managing these social determinants of health remains key to promoting equitable access to healthcare (Nooraie et al., 2020). These form the basis for preventative services and policy development in promoting equitable healthcare access to [population. For example, translational research in areas such as health insurance coverage has led to developments to ensure equitable access to healthcare services by individuals with chronic illnesses. It also helps institutions test interventions in populations before implementing them, thus reducing harm to the population.

The Telehealth policy under Social Security Act (waiver 1135) was previously enacted to promote equitable access to healthcare. The policy was developed after extensive research evaluating the merits and demerits of physical physician clinic visits. The policy also relied on research testing the effectiveness of telehealth during the COVID pandemic. COVID-19 increased the need to enhance social distancing to prevent its spread. Smith and Raskin (2021) note that the telehealth policy was enacted to promote access to healthcare services by ensuring telehealth visits were enacted like physical clinician visits and were paid for by the CMS and other healthcare insurance coverage institutions.

The policy has increased access to remote healthcare services access using audio only. Telehealth allows patients to access consultation services for various conditions while in the comfort of their homes; remotely. The policy has led to the expansion of telehealth services in critical areas such as managing chronic illnesses (diabetes, cancer, and heart disease) and home care. The policy has promoted equitable care through improved access to services for the population with the greatest need. Most CMS patients are from low-income families, with chronic illness, and those above 65 years (Smith & Raskin, 2021). Increasing access to telehealth by allowing CMS to pay for these services has greatly improved equity in healthcare access.

References

Nooraie, R. Y., Kwan, B. M., Cohn, E., AuYoung, M., Roberts, M. C., Adsul, P., & Shelton, R. C. (2020). Advancing health equity through CTSA programs: Opportunities for interaction between health equity, dissemination and implementation, and translational science. Journal of Clinical and Translational Science, 4(3), 168-175. https://doi.org/10.1017/cts.2020.10

Smith, S., & Raskin, S. (2021). Achieving health equity: Examining telehealth in response to a pandemic. The Journal for Nurse Practitioners, 17(2), 214-217. https://doi.org/10.1016/j.nurpra.2020.10.001

Topic 8 DQ 2

Description:

As an advanced registered nurse, discuss your future role in advocating for equitable population health services and policies. Do you anticipate any challenges or barriers to “population advocacy”? How would you meet these challenges?

NUR 550 Topic 8 DQ 2

Advanced practice registered nurses play overarching roles in population advocacy and advocating for equitable population health services and policies. Health equity positively affects population health outcomes, including care access and utilization (Chin et al., 2018). Self-assessment helps determine perceived threats to self-efficacy and mitigate them to ensure quality care delivery and role execution. Advanced practice nurses are involved in policy development and evaluations (Williams et al., 2018). They should ensure the policies developed promote equitable population health services and policies.

Another role is promoting the development of legislative policies that support equitable population health services and policies. These include providing professional reviews to bills and legislation and offering expertise to individuals with the power to develop policies that affect population health. Other roles include participating in research evaluating population health policies to determine their impact on population health outcomes and care equity (Williams et al., 2018). 

According to Williams et al. (2018), APRNs sensitize patients on legislation affecting their health to increase their access to healthcare. They also improve their knowledge of existing resources to improve their health outcomes. For example, I will include individuals on Medicaid expansion and the special CMS programs for chronic illnesses such as ESRD, Cancer, Diabetes, and heart disease. The interventions will enhance their knowledge and care services utilization, thus promoting equitable care access and better population outcomes.

However, not all nurses are involved in population health policy development, and thus my input in promoting the development of these policies may be negligible. To overcome these barriers, I will enhance my knowledge and skills and advance my education to increase my chances of securing managerial positions at the state or federal level. These positions will provide a better platform for policy-making roles and will thus positively influence this desired role. Another barrier is the lack of support from the health institution and interprofessional teams, as supported by Williams et al. (2018). 

Making a significant difference as an individual can be difficult, and a lack of support from interprofessional teams and institutions may worsen the situation. Sensitizing the institution’s leaders and other healthcare professionals on the importance of population health advocacy and garnering their support will improve. Implementing the abovementioned roles and tackling the anticipated barriers to advocacy will enhance my advocacy roles as an advanced practice registered nurse.

References

Chin, M. H., King, P. T., Jones, R. G., Jones, B., Ameratunga, S. N., Muramatsu, N., & Derrett, S. (2018). Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health Policy, 122(8), 837-853. https://doi.org/10.1016/j.healthpol.2018.05.001

Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse Advocacy: Adopting a health in all policies approach. Online Journal of Issues in Nursing, 23(3). https://doi.org/10.3912/OJIN.Vol23No03Man01

Also Read:

NUR 550 Topic 2: Epidemiology, Biostatistics, Genetics, and Genomics

NUR 550 Topic 3 Translational Research Framework and Legal and Ethical Considerations

NUR 550 Topic 4: Critical Appraisal of Research