(Answered) Healthcare Policy

(Answered) Healthcare Policy

(Answered) Healthcare Policy 150 150 Prisc

Healthcare Policy

  1. Select a policy at the institutional, local, state, or federal level in the USA that affects you and/or your workplace. For example, it may be a policy that you have observed in your current clinical setting or one that you have read about in a professional journal or newspaper. Give a brief overview of the policy. What is the overall impact of the policy in healthcare? How does the policy impact you and/or  workplace?
  2. Determine how nurses or other healthcare professionals view the policy. You can do this by clinical staff putting the policy into action, or locating readings that discuss how the policy has been received.
  3. Find and briefly evaluate evidence-based practice literature pertaining to your selected policy. You’ll need at least three source of scholarly articles that pertain to the policy you selected.
  4. What are the barriers to implementing the policy? If it has already been implemented, what are the barriers to modifying the policy?
  5. Based on what you’ve learned, do you support the policy or want to see it changed? Why? What changes do you recommend to the policy? What can nurses do to support or change the policy?

Sample Answer

Policy at Federal Level

One of the major policies affecting healthcare facilities is the Hospital Readmissions Reduction Program (HRRP), which was established under the Affordable Care Act and launched in late 2012.  The regulation requires the center for Medicaid and Medicare services to decrease the amount they pay to hospitals that register higher readmission rates. Readmissions, in this case, refer to repeated admissions in healthcare facilities within 30 days after discharge among CMS participating hospitals. Conditions such as heart failure, acute myocardial infarction, pneumonia, and COPD are the major focus of this policy. The overall impact of the regulation is that it ensures that hospitals are more active in ensuring that the quality of care they provide to their patients is quality and the right management practices are in place to prevent readmissions. It also lowers healthcare costs associated with readmissions. Impact on individual care facilities includes better collaborations among the care providers to improve the quality of care and prevent patient readmissions (Center for Medicare and Medicaid Services, 2021).

Determine how Nurses or Other Healthcare Professionals View the Policy

The policy is well accepted and has been implemented across various healthcare facilities. According to the existing data, the conditions covered under HRRP decreased from 21.7% in 2007 to 17.8%, which is a significant difference, while those not covered did not decrease. Over the years, the number of healthcare facilities receiving the maximum penalty of the 3% has decreased to about 1.8% of the total hospitals under CMS, which indicates that the regulation has been embraced by healthcare professionals and is being implemented to improve the quality of services they provide (Catalyst, 2018).

Evaluate Evidence-based Practice Literature Pertaining to your Selected Policy

Marbach et al. (2018) conducted the study to determine whether the AMI care coordination program would decrease readmission rates among AMI patients. They established that patients who receive AMI-specific care coordination indicated a 48% decrease in odds of requiring readmission within 30 days. Therefore, the inclusion of AMI-specific care coordination significantly reduces the risk of readmissions within 30 days.

Benjenk and Chen (2018) conducted a systematic review to determine if interventions that address mental health can be used to effectively reduce readmission rates among patients following hospitalization for physical conditions such as acute myocardial infarction (AMI). They found that interventions such as group and individual psychotherapy effectively decreased readmission rates for patients admitted with physical conditions such as AMI. The review, therefore, recommended the use of mental health intervention to reduce readmission rates for physical health conditions.

Warchol et al. (2019) conducted a study to determine healthcare leaders’ strategies to decrease readmission rates in the non-Medicaid-expansion state. Under population health, some of the strategies included improving care coordination across the continuum, ensuring patient education, and developing approaches that fit the local community. Under hospital operations, identified strategies include promoting multidisciplinary teams and interprofessional teams in the facility and regular monitoring of EHRs to identify patients at risk, therefore, provide special attention.

Barriers to Modifying the Policy?

A major barrier to implementing the policy is that not all factors contributing to the reduction in hospital readmission rates are within healthcare facility control. There are factors such as patient lifestyle decisions that hospitals do not control and contribute to hospital readmissions. Such factors limit the effectiveness of readmission prevention efforts by healthcare facilities (Catalyst, 2018).

Do you Support the Policy or want to see it Changed?

While the policy has been effective in reducing readmission rates, several shortcomings have been identified and need to be addressed, including the current method of calculating policies that follow a fixed rate; risk adjustment for some facilities has been identified as a major issue but is the 21st Century Act has partially addressed it. The penalties should be calculated based on national averages rather than the fixed rates currently used. Nurses can ensure the adoption of evidence-based interventions in their practice to support the reduction of readmission rates, improve the quality of care and lower the cost of care services (Catalyst, 2018).