Healthcare Policies

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Instructions:

This assignment must be done in APA format. It is broken down into 2 questions. A minimum of 1600 words (references is not included) for the overall assignment is required. The minimum reference count is 4 (including in-text citations) for the overall assignment. Also, even though this assignment is done in APA, it must keep the question, answer, and reference format. Please see example below.

 

Format: Question: XYZ

Answer: XYZ

Reference: XYZ

 

Articles for questions:

https://www.ahrq.gov/research/findings/factsheets/index.html

https://www.cdc.gov/nchs/healthy_people/hp2020.htm

 

  1. Population health is a critical facet of managing health. The US government has taken a proactive role in this arena. For example, over the past few decades the Center for Disease Control has prepared a series of Health People initiatives, with the most current being Healthy People 2020. In a narrative form identify and discuss at least 5 key reasons for managing population health.

 

 

  1. Select one aspect of population, either nationally or globally, and discuss it in depth.

 

 

Part Two: This part of the assignment is simple. The minimum word count for this assignment is 250 words (per response); with one reference each.

 

Note: Write as if you’re actually talking to the person.

 

 

  1. Population health and public health are often mistaken for one another because of their similarities. Public health is about protecting and improving the health of communities through policy recommendations, education, outreach, research, and prevention while population health the act of healthcare entities, agencies, and other organization working together to improve the health of the communities that they serve (CDC, 2019). Public health has a larger focus while population health focuses on specific needs and opportunities for improvement. Population health is something that can be improved on and affected at many different levels. Population health can be anything from the homeless to pediatrics to a specific diagnosis such as congested heart failure.

 

The health of populations can be improved by healthcare policy. The policies that have aided in population health include but are not limited to Medicare, Medicaid, Children’s Health Insurance Program, and the Affordable Care Act. Medicare, Medicaid, and CHIP each aim to improve the health of specific populations. Medicare focuses on the elderly, Medicaid focuses on the low-income, and CHIP focuses on children. The ACA was almost successful in expanding Medicaid nationwide which would have helped a larger amount of low-income people.

There is also another aspect of the ACA that reflected on population health was the implementation of value-based care. A value-based care system is a system that has a goal of improving population health by providing incentive payments to providers and entities for their quality of care (CMS, 2019). The better the quality of care the better the payment. That being said it does not stop at the care that is provided at the physician’s office or hospital, but it continues onto outpatient care to aid in readmission rates. This is were a different organization and entities work together to treat the population. Population health and value-based care may be two different concepts and focuses but the two work together to improve the health of populations.

 

 

 

  1. Population health is defined as “the health outcome of a group of individuals, including the distribution of such outcomes within the group”(Hendrikx,Drewes& Baan,2019). It focuses on people’s perception of resilience, ability to adapt and self-manage. The CDC states that population health allows health departments to connect practice to policy for change to happen locally. Public health is another concept that is similar, it tries to improve the health of communities through policy recommendations, health education and outreach, and research for disease detection and injury prevention(DiClemente & Wingood,2019). Population health deals with multiple sectors such as education, health care, social services, urban development and housing. It works to improve health through local, regional and national levels. Public health is broader, while hospitals and Doctors treat and care for sick patients public health is working to prevent people from getting ill in the first place. Public health promotes wellness and its scope ranges from immunizations in adolescents and adults to preventing the spread of diseases.

 

Policies that currently exist to promote population health are taxes on cigarettes and alcohol, smoking bans, menu labeling at restaurants, seat belt laws and water fluoridation. The Affordable Care Act was aimed at improving healthcare through state funded programs such a Medicaid(income based) and the CHIP program(children). Value driven health care is becoming more popular by giving financial incentives through pay-for-performance programs. Linking payment to hospital and Physician performance is an incentive to improve the quality of care(Dy, Sharma & Isenberg,2018).

 

  1. The term population health is not a new term since it was introduced in 2003 and has continued to evolve every sinceit’s introduction. Population health refers to, “the health outcomes of a group of individuals, including the distribution of such outcomes within the group” (Kindig, 2015). There are three categories that it focuses on and they are, health outcomes, health determinants and policies. It’s important to consider that when policies are implemented regarding population health, external environmental and social factors such as clinical care, public health, genetics, behaviors (smoking, diet, treatments), employment, education, poverty are all taken into consideration. Population health can also be looked as the science of analyzing “the inputs and outputs of the overall health and well-being of a population and using the gained knowledge to produce desirable population outcomes” (Astho, 2018). The term population health is also commonly mistaken for public health which refers to, “the science and art of preventing disease, prolonging life, and promoting health through organized efforts” (Astho, 2018). It is important to understand the difference between the two terms and take note that population health has gained momentum due to being more commonly used in the Triple Aim concept and clinical settings. Triple Aim refers to a framework used for population health to point out key focuses which are, “improving the health of populations, improving clinical outcomes and lowering healthcare costs” (Astho, 2018). Healthcare polices have aided in achieving positive population health outcomes. Medicaid is one of the healthcare policies that have aided in the improvement of population health by addressing the social determinants of health and creating the conditions under which individuals can thrive. For example, with the assistance of the ACA, Medicaid was able to be expanded to provide coverage for, “community-based services, using health workers to deliver service, and hospital community benefits are examples of how population health was achieved by addressing health at a community level” (Astho, 2018). Another example of a healthcare policy that has focused on population health would be Medicare. The new Medicare Advantage policy is focusing on, “aiming benefits to improve health outcomes by addressing issues such as housing and food insecurity, transportation and social isolation” (Bryant, 2018).

On the other hand, value driven care is a fairly new term that was introduced in 2014 in order to, “replace the nation’s reliance on fragmented, fee-for-service care with comprehensive, coordinated care using payment models that hold organizations accountable for cost control and quality gains” (LaPointe, 2018). The term value drive care or value-based care refers to, “a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness” (LaPointe, 2018). The Centers for Medicare and Medicaid Services (CMS) have taken the lead regarding effective implementation this new concept. CMS has introduced different value-based care model such as Medicare Shared Savings Program and Pioneer Accountable Care Organization (ACO) model. In the ACO model, “doctors, hospitals, and other healthcare providers work as a networked team to deliver the best possible coordinated care at the lowest possible cost” (LaPointe, 2018). In this model, each member would share both risk and reward with incentives to improve access and quality of care. Lastly, it is important to take note that value-based care, “aims to advance the triple aim of providing better care for individuals, improving population health management strategies, and reducing healthcare costs” (LaPointe, 2018).

 

Last Updated on June 16, 2019