Health Insurance Coverage To Enhance Access to Care In The USA Essay
Healthcare Program/Policy Evaluation Analysis Template
| Healthcare Program/Policy Evaluation |
The Patient Protection and Affordable Care Act (commonly referred to as “Affordable Care Act” (ACA) |
| Description | ACA is a policy that was enacted in 2010 as a major comprehensive national healthcare reform with the aim of expanding health insurance coverage to enhance access to care in the USA (Ercia, 2021). The objective of this policy was to increase access to healthcare services for Americans, enhance the quality of care, and control healthcare costs. To increase health insurance coverage by expanding the Medicaid program to cater to adults with incomes of 138% of the federal poverty level, introducing a health insurance marketplace for individuals and small businesses, thereby making it possible to get private health insurance, enforcing the individual mandate requiring the eligible individuals to have federally approved coverage (Ercia, 2021). Health Insurance Coverage To Enhance Access to Care In The USA Essay
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| How was the success of the program or policy measured?
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One of the main ways through which the ACA is evaluated is by measuring the change in uninsured Americans. Following the implementation of the ACA, the number of Americans with no health insurance reduced by 13.3 million between 2013 and 2017 (Buettgens et al., 2021). There was a notable increase in the enrollment rate in Medicaid and the Children’s Health Insurance Program (CHIP) by 16.6 million, which was approximately a 29.3% rise.
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| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? Health Insurance Coverage To Enhance Access to Care In The USA Essay
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The Department of Health and Human Services reported that as at 2023, the health insurance coverage gotten as result of the Affordable Care Act (ACA) market places, Medicaid expansion, Children’s Health Insurance Program, Basic Health Program, and subsequent states’ intervention following the implementation was more than 40 million Americans.
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| At what point in program implementation was the program or policy evaluation conducted? | The evaluation of ACA was carried out on an ongoing basis and has been conducted on an annual basis since 2010. |
| What data was used to conduct the program or policy evaluation?
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The data used to evaluate the effectiveness of ACA included the reduction of uninsured Americans in America. This was assessed using data acquired from the individual marketplace, Medicaid expansion, and employer-sponsored insurance. Another data used to evaluate the effectiveness of ACA is a reduction in healthcare costs.
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| What specific information on unintended consequences were identified?
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One unintended consequence of the ACA was the rise and expansion of hospital monopolies. There was a notable increase in hospital mergers and acquisitions, leading to the formation of healthcare conglomerates. This has been described as an unintended impact of ACA since the ACA encourages a narrow network of healthcare providers and the establishment of accountable care organizations, a healthcare system that rewards efficiency in resource utilization in a bid to lower unnecessary healthcare expenditure. Health Insurance Coverage To Enhance Access to Care In The USA Essay |
| What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
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The stakeholders identified in the evaluation included policymakers, healthcare providers, insurance companies, patients, advocacy groups, and regulators. Policymakers are among the key beneficiaries of the policy evaluation since the results help in making informed decisions regarding healthcare policy. Advocacy groups are also likely to benefit from the program since they can utilize the result to raise awareness of significant healthcare issues and push for further changes. The general American public is likely to benefit from the program evaluation since it is likely to assist them in learning about the effectiveness of the various healthcare programs and policies.
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| Did the program or policy meet the original intent and objectives? Why or why not? Health Insurance Coverage To Enhance Access to Care In The USA Essay
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The ACA meets its original objectives. According to Sommers et al. (2017), ACA resulted in a 41% increase in insurance coverage, a $337 decrease in the annual out-of-pocket expenditure, and an improvement in healthcare outcomes. The increased health insurance coverage contributed to improved outcomes due to affordability of care, regular care, improved medication adherence, and self-reported health. Despite this, the implementation of ACA has been faced with significant legal challenges, which has hindered its comprehensive implementation.
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| Would you recommend implementing this program or policy in your place of work? Why or why not?
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As a healthcare provider, my recommendation would be to support and expand the provisions of the ACA that have been noted to be effective in increasing insurance coverage, enhancement of healthcare access, and improvement of quality. It is, however, important to review the areas where shortcomings may be noted to address the challenges faced and the unintended consequences.
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| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation. Health Insurance Coverage To Enhance Access to Care In The USA Essay
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As a nurse advocate, I would become involved in evaluating the program by participating in the data collection and analysis process on ACA’s impact on patient outcomes within the healthcare facility. Another approach would be engaging in active advocacy initiatives to create awareness of the successes and challenges of the ACA to policymakers and other relevant stakeholders on possible changes to the policy to help optimize its effectiveness.
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| General Notes/Comments | Despite being regarded as being a controversial policy in the healthcare sector, the ACA has had a significant impact in reducing the number of uninsured people to historically low levels and making contributions to enhancing access to healthcare services, especially among the vulnerable of society such as the low-income individuals. Health insurance contributes to a general net positive impact on healthcare (Willage, 2020). It is, however, important to further amend the policy to help enhance the positive outcomes as well as resolve the unintended consequences. The implementation of ACA has faced several blocks, especially on the legal aspects and access provision.
Health Insurance Coverage To Enhance Access to Care In The USA Essay
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References
Buettgens, M., Blavin, F., & Pan, C. (2021). The Affordable Care Act Reduced Income Inequality In The US: Study examines the ACA and income inequality. Health Affairs, 40(1), 121-129. https://doi.org/10.1377/hlthaff.2019.00931
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas. BMC health services research, 21, 1-9. https://doi.org/10.1186/s12913-021-06961-9
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the Affordable Care Act: improved medical care and health among low-income adults. Health Affairs, 36(6), 1119-1128. https://doi.org/10.1377/hlthaff.2017.0293
Willage, B. (2020). Unintended consequences of health insurance: Affordable Care Act’s free contraception mandate and risky sex. Health economics, 29(1), 30-45. https://doi.org/10.1002/hec.3967 Health Insurance Coverage To Enhance Access to Care In The USA Essay
