Policy Plan Proposal

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Policy Plan Proposal

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Executive Summary

Below is an executive summary of the Colorado healthcare system. It contains medical professionals that provide services relating to diagnosis, treatment, and preventive measures to injuries as well as mental illness (Birkland, 2015). The policy pertains to healthcare involves both establishing as well as implementing legislation and also other regulations that the States use to manage the health care system effectively. The citizens of Colorado pay for medical services where they must, on the other hand, access quality healthcare. This will, therefore, create a need to have laws being designed as well as implemented so that the efficiency in the healthcare sector can be maintained in Colorado.

This paper is going to contain a segment relating to the problem statement. This part is going to explain the decline standards of medical care in the United States of America. This has therefore led the implementation of various policies to curb the above the declining standards. The policies aim to offer long term solution to the problems (Mitton et al., 2009). One of the solutions is coming up with a sustainable healthcare care payroll calls structure. This will call for deduction of employees which will, therefore, lead o loss of jobs as well as the increased burden of expenditure.

The principal objective of the policy plan is to carry out an extensive investigation of the role of legislation relating to the management of the healthcare sector. In this paper, both quantitative, as well as qualitative methods, will be used for the purpose of data collection. This method will make sure that both practical as well as theoretical aspects of the research. As per the answers, the policy needs choosing survey as the research design (Birkland, 2015). This method entails collecting and analyzing data from people that are representing the primary group that is in healthcare. These methods automatically will face challenges such as attitudes as well as the perception of the healthcare workers that leads to the delimitation of the study. The participants are going to be selected using stratifies random sampling.

The primary stakeholder during this research is going to include; legislatures, local government, patients, and private parties such as insurance. These stakeholders will assist in the healthcare sector, where they will assist in the making of decisions. They will be used to identify the areas of agreement as well as disagreement, which will, in turn, result in a good understanding of the crucial driving areas (Mitton et al., 2009). They will also assist in the improvement of the level of trustworthiness that will generally lead to the provision of quality services. The dialogue will be the means for interacting whereby the opinions, as well as ideas of the various stakeholders, will be shared in regard to implementation of health policy.

The paper is also going to illustrate the effect of the problem. This is where creation, as well as the implementation of the policy plans, will result in the health care sector to decline or reduce the health effects (Birkland, 2015). There are various mechanisms that will be stated in this paper regarding dealing with multiple challenges. Poverty is one of the main problems that face the provision of health care. Level of inequalities hinders the ability to acquire quality health care.

This paper is also going to state the policy strategies that need to be focused on in order to ensure the provision of quality healthcare. Transparency is one of the policy strategies. This is whereby clients have a chance to ask about their treatment cost as well as options. The other is payment reforms concerning the treatment of the clients (Birkland, 2015). This reform will ensure that the medical expense will be made affordable. Consideration of social determinants in healthcare is also vital. Lastly, it is also essential when it comes to the issue of maintaining the knowledge of how the healthcare system is progressing. This will make sure that the care received by patients is both affordable as well as effective.

This paper will also include a policy recommendation. Generally, policymaking is usually a tedious process since it involves a number of technical aspects that need to be taken into consideration in order to come up with a favorable recommendation (Mitton et al., 2009). The policymakers should have enough knowledge in the field of data so as to come up with the best solutions in the policymaking it better to involve the employees of the organization. Presence of them will enhance both credibility as well as transparency process. An informative announcement of the process that is being taken should be a step toward the procedure relating to fixing prices. This statement is going to resolve the conflicts between policymakers as well as clients. This concern is going to decrease among the public, therefore, restoring the confidence of the policy as well as the policymakers.

Introduction

Different regions have got their own healthcare system. In our case in Colorado, policymakers want to develop a policy plan that is going to ensure that they will provide quality healthcare services to the patients in that region (Birkland, 2015). Various recommendations are going to be stated by the multiple stakeholders, but only the appropriate will be implemented into the healthcare sector for its benefit. The policymakers need to be reasonable so that they can come up with policies that are going to favor patients as well as the healthcare sector. The rationale in the policy making must also be favorable to the stakeholders involved. This will generally result in the provision of better health care services.

Defining the Problem

The health care system in Colorado is a composition of medical professionals providing services such as diagnosis, treatment, as well as preventive measures to mental illness and injuries (“Healthcare policy in Colorado – Ballotpedia,” 2019). Health care policy involves the establishment and implementation of legislation and other regulations that the states use to manage its health care system effectively. Further, this sector consists of other participants, such as insurance and health information technology. The cost citizens pay for medical care and also the access to quality care influence the overall health care providers in Colorado. Therefore, the need for the creation and implementation of laws that help the state maintain efficiency in the health sector in Colorado.

Problem Statement

The declining standards of medical care within the United States has caused significant concern in the world. Due to these rising concerns, there have been various policies implemented, leading to mixed reactions among the different states. Some of the active policies implemented offer a long-term solution to this problem including Medicaid and Medicare. After acquiring state control, the Republicans dismissed the idea to expand and create medical insurance for Medicaid in Colorado. Sustaining the structure of the health care payroll calls for the deductions from the employees and the employers, which may lead to loss of jobs and increased burden of expenditure (Garcia, 2019).

Identify the Methodology

The main objective of this policy plan is to investigate the role of legislation in the management of the health care sector in the United States. Due to the need for achieving in-depth exploration, this paper uses a combination of both qualitative and quantitative methods of data collection by addressing both practical and theoretical aspects of the research. Based on the answers that the policy requires, choosing survey as the research design. This method involves collecting and analyzing data from a few people who represent the principal group within health care. However, the survey method faces some challenges such as attitudes and perception of the health workers leading to the delimitation of the study. The target population for the study includes the nurses within the health sectors in Colorado. The selection of the participants involved in the use of stratified random sampling.

Identify your Stakeholders

The major stakeholders in the creation and implementation of the policy plan include the legislatures, local government, patients, and other private parties such as the insurance companies. Collectively, these bodies are involved in the making of thousands of decisions, overseeing hospitals, making budgetary appropriations, assisting the health workers to acquire licenses, determination of services that the insurers cover, and the management of personal health information. The engagement by stakeholders involves the identification of areas both agreements and disagreements, leading to better understanding of the critical driving areas. Further, the input of the stakeholders helps in the articulation of values, the community affected by the changes leading to the alignment of the expected recommendations. Again, the roles played by the stakeholders help in the improvement of levels of trustworthiness that lead to the provision of quality care. The process of policymaking also involves the development of several frameworks that help in planning for the implementation of the policy (Who.int, 2019). Most importantly, the parties involved in the policy creation and implementation, engage in dialogue processes calling for the government’s support tailored for collaborations. These collaborations enable the various participants in collecting and sharing information that is vital in the implementation of independent health policy.

Determine the Effect of the Problem

Creation and implementation of policy plans within the health care sector lead to the decline of the full health effects (Dave & Dhruv, 2018). Due to continually growing income disparities, there are reported cases of morbidity and mortality based on the income distribution among the citizens of the United States. Through various mechanisms such as behavioral, clinical, environmental, and social, the health and longevity of the individuals can face several challenges. By intersecting many social work risk factors, it is possible to isolate the contributions that income makes towards improving the quality of health care delivery. Again, individuals with poor health have higher chances of facing reduced income leading to a health-poverty trap. In recent decades, there has been a dramatic increase in the levels of income inequalities in the United States. The provision of health care has faced a significant challenge due to poverty leading to deaths and diseases, but recently, the government shifts focus towards establishing the link between income and provision of services at the health care facilities. The health care system in the United States recognizes that some non-clinical factors such as ethnicity, race, unemployment, and geography, may create influence over the health outcomes. Over time, there has been growth in income disparities, leading to economic inequalities that also affect life expectancy in Colorado. Moreover, more reports indicate that there are higher levels of physical limitations among the Americans earning low income compared to those who receive more elevated amounts of income.

Identify the Resources and Benchmarks

The understanding and transformation of the health care system dramatically depend on power. Through power, there is the manifestation of implicit and explicit interactions of the diverse health care system. Based on these interactions, patients and care providers also engage in the negotiations that lead to the creation of health policies. Furthermore, power presents itself at every level of intervention of the health care provision shaping all the outcomes. On the other hand, benchmarking helps the stakeholders to determine the viability of their policy by comparing it to other existing systems. It seeks to confirm whether the policy plan creation and implementation take place effectively. The main idea behind benchmarking is to enable the team to measure and compare their practices to those of external operators. Through benchmarking, the participants can review and make changes to the policies before implementing them.

Focusing on a Strategy

The health care policies in Colorado have led to the increase in household expenses for many years and it is anticipated to keep increasing. This increase in expenses impacts a significant amount of families specifically those who are trying to make ends meet. Challenges on health care costs and spending are typically used interchangeably by policy makers but have different meanings. Determining ways to handle the issue of health care costs as well as other issues related to health care policies in Colorado is essential for the state’s residents (William, 2017).

Transparency

Increasing transparency is one way that can be used to address the issue of healthcare policies in Colorado. The raising of drug prices has brought about a huge conflict among the policy makers and the consumers. New drugs are introduced and put on the market at high prices and many individuals know that the high prices are a great risk in the pharmaceutical industry. These high-priced drugs have confused and disappointed the customers and the policy makers. The various states use the policies that require transparency of pharmaceutical prices in order to force the pharmaceutical companies to take responsibility for the high prices. The manufactures are expected to provide information on rising prices and making the information available to the public. Price transparency enables cost control through customer motivation which has become the main goal among the policymakers.

Transparency aids in enhancing the quality of care as well. It helps hold the physicians responsible for patient care, thus encouraging better patient care, as well as enhancing healthcare productivity. The healthcare administrators control the system that is used for motivating the providers and set policies that encourage better efficiency in making them work more efficiently. It also aids in minimizing operating costs. This is achieved by the fact that transparency improves productivity, thus lowering the cost. It enables the employees to come up with ideas to aid in the financial stability of the health care facility. Transparency with the financial needs of each department can lead to better decision making by the staff that works within the department. For example, emergency room staff will have difficulty regulating the cost of the operating room when they do not possess the knowledge of the cost incurred on the operating room resources.

Changing the health care culture where prices are kept undisclosed can be a great challenge to transparency. Transforming this belief involves changing the workers’ perceptions which can lead to workplace politics. Sometimes obtaining the information from organizations that should be public knowledge becomes difficult. Specific individuals have access to the information needed for transparency however, they need to concentrate on their duties rather than serving the management the information for transparency (USC, n.d.).

The Internal and External Impacts for Transparency

With the health care system being transparent it has cut the ability for political corruptions ability to force a reduction in medical staff, this could change the sanctioned cost to serve the patient. The government may demand payment for drugs that are normally given at no cost. It has also reduced the loss public resources through the use of regulations. The social aspect that can affect health care is that health care transparency keeps the costs lower and raising the living standards of the community. With an impartial medical treatment cost, individuals can afford to have the necessary treatments that they may need thus, reducing the mortality rate.

Other influences that affect healthcare policies are legalities, cultural, and fiscal constraints. Transparency among each of these aspects allows for the health care sector to maintain proper care of patients. The legal aspect excludes unlawfulness since things are done in the appropriate manner without biases. Cultural aspects enhance the relationship and trust between physician and patient in the health care facility, it also allows for quality and efficiency within the system. The fiscal constraints make sure the health care program does not exceed the anticipated income within a fiscal year.

The Financial Mechanisms and Budgeting Approaches for Transparency

The financial side of transparency includes indirect costs, direct costs, and cost-sharing. Some of the indirect costs include health facilities themselves, patient transportation to a health facility. Indirect costs involve innovative ways to financing such as raising funds for growth, such as funds from taxation. The next way is direct cost this is activity-based budgeting and is used to find out the total number of inputs needed to support the expected result of implementing the strategy. Then there is cost-sharing this strategy is where the patients will have to pay the portion that is not covered by insurance.

Payment Reform

Another approach that can be used to address the problem of health care policies is the payment reform. The government should reduce health care costs and make it affordable for all. It should encourage experimentation with new approaches to prices and payments such as the consumer-based care and payment methods. It should also analyze the potential of equalizing payments in rural places across the nation. It should improve the primary care payments using value related structures such as primary care payment (William, 2017).

Through payment reform, healthcare costs are reduced, this approach is mainly intended for individuals that have to spend money on their healthcare. These efforts do not have a solid success and need to have flexibility at all times. Payment reform enables individuals to manage their expenses in a sensible way. There are strategies that have been put in place to limit the financial requirements for an individual, which establishes a deduction in the spending of the GDP.

There are always financial costs required for the reformations, these changes are expected to save money for patients. The issue with these reforms is that there is always upfront capital required to allow things to flow in the right direction. Payment reforms also transform the condition of how care is provided. This may include minimized hours for employees to transition to where the cost of the care lies (Ayres, n.d.).

Internal and External Impacts for Payment Reform

Through the introduction of payment reform, the political-economy obstacle will be extracted this will lead to the attraction of more donors from some organizations. The higher the costs of healthcare, the less income people have to spend on other goods and services. High health care costs can lead to a reduction in the access to proper health care and higher debt for consumers thus lowering the rate of growth in GDP. Lower cost of health care for children provides a chance for better health as an adult it also improves the social welfare of families. With this strategy it will fill in the loopholes within the healthcare system and provide access to healthcare to the members of society. Healthcare payment reform has brought changes to cultural beliefs. For example, the belief that health care is not affordable for lower income and is only available to the wealthy is not accurate. Some fiscal restraints for healthcare payment reform is it has a negative impact on the government’s fiscal position since solvencies are used to cater to new spending programs.

Financing Mechanism and Budgeting Approaches for Healthcare Payment Reform

The financial side of the healthcare payment reform includes indirect costs, direct costs, and cost-sharing. Like transparency, healthcare payment reform has indirect costs that include transportation for patients to healthcare facility. Again, like transparency indirect costs involve innovative ways to financing such as raising funds for growth such as funds from taxation. The direct costs are paid by the patient for the services received and can cause financial strain on the average person. Cost-sharing involves the sharing of costs between the government and the patient. It uses the government financing mechanism for the government pays some of the costs incurred (McGraw-Hill Medical, n.d.).

Social Determinants

Social determinants of health care are also a factor that needs to be considered when addressing the issue of healthcare policy problems. There needs to be a minimum of national agencies to ensure medical patients get the support required to deal with their medical conditions, supports could include housing, training, and placements. They are also expected to provide the payment in the conditions set by Medicare that deal with coatomer’s social determinants of life. Hospital management is also expected to develop a preliminary program that determines urban, low-income patients and provide them with improved care and financial support (William, 2017).

Social determinants of life are mainly used to consider the least disadvantaged people in society. Social determinants of health impact health results as well as biological and individual factors. It is important since it aids in ensuring that low-income patients are provided with enhanced care and financial support. By using the data provided by social determinants, physicians may have a better understanding of the patients’ needs and determine effective ways to treat them (Bernazzani, 2016).

Consideration of social determinants of health has less limitations on minimizing racial and ethnic inequalities. When resources are unavailable, social determinants can develop unpleasant events such as discrimination which involves the dynamics of social injustice. This results in poor health results and may affect various generations, even if discrimination is not present (Bernazzani, 2016).

Internal and External Impacts in Social Determinants

Consideration of the social determinants of health will eliminate the political-economy obstacles, this will lead to equal opportunities among health care. Due to the consideration of the social determinants of health care, the number of deaths due to lack of healthcare, education and racial segregation has reduced as well. The legal aspect is the consideration of the social determinants of health and will aide in displaying equalities among all individuals and of all living standards. All individuals will have the ability to attain the proper health services that may be needed. Social determinants of healthcare bring understanding and consistency among the patients and the clinicians in the healthcare facilities. It can also enhance the quality and efficiency in the healthcare system. The fiscal constraints have a positive impact on the government’s fiscal position since they bring the patients closer to the healthcare providers.

Financing Mechanisms and Budgeting Approaches for Social Determinants

The financing and budgeting approaches include indirect costs, direct costs, and cost-sharing. The indirect costs include classrooms used by patients and transportation for medical purposes. The direct costs involve money used to pay the clinical staff, health coverage and training staff needed during the process (McGraw-Hill Medical, n.d.). In the consideration of social determinants of health, they are no application of cost-sharing since the federal government is responsible for catering for all the requirements for those in need. It involves the government financing mechanism.

Policy Recommendation Paper

Health care issues are considered important and they need to be addressed, sometimes immediately. These health care issues occasionally create an issue that can be difficult to handle. The working families cannot afford to pay their bills and pay for insurance therefore, they sacrifice spending money on the health care making it possible to have more serious health issues later. There can be several ways to bring reforms forward and repair these issues. It is important to provide ideas and solutions to reduce the costs of health care for families that struggle with obtaining such care.

Description of Policy Recommendation

Transparency in the actions of providing health care solutions will bring efficiency in the process. There is always a conflict about the cost of health care between the policy makers and the people it affects. It is a fact that what is charged to the patient for medications is far higher than what they cost the medical facilities and the pharmaceutical companies. A sudden rise in the price of the drugs brings fear, frustration, and desperation among the patients that need them. They blame policy makers for such a sudden increase (“National Health Expenditure Fact Sheet”, n.d.). But they don’t know the actual causes behind the decisions. It is, therefore, mandatory to bring transparency into the system for this cause of the rising drug prices. The policy makers should include the pharmaceutical companies in the decision process to make it a more clear and valid process.

The pharmaceutical companies should be directed to reveal all the information and pricing for the medications and make it available to the general public. This disclosure will aid in the building of trust and belief with the consumer. Transparency will also enhance the quality of health care services by offering quality care and cost-effective medications, allowing health care practitioners to perform the best health care services to the patients. This will also lower the chances of mistakes being made and malpractice suits from being filed. The reasonable and fair practice of medicine will also cut the price of health care. When quality products and health care are available at reasonable prices it makes way for health care to bring better health practices to the public and therefore, allow the population to live a long and healthy life (“National Health Expenditure Fact Sheet”, n.d.).

Transparency should be present at each step of the health care process; it is important to change the practice of non-transparent procedures of price setting within the health care department. It is a difficult task to get the information from the manufacturers about the process of setting the prices of the drugs and why they are set at that price. This information was not made public and the little information that was permitted to be released was not very informative. Even the employees of the pharmaceutical companies have been instructed to maintain silence about the pricing process among other confidential information. This lack of transparency needs to be changed to set an example to the public that the companies are not hiding anything. There is a high demand for the awareness within the workplace and among the policy makers to change the way they are being perceived. It will enhance the chances of transparency in the system that will lead an effective and efficient implementation of pricing policies in the health care sector. In turn, it will pave the way for the public trust to return to the health care system.

Transparency is an important way to bring a positive solution in cutting the costs of health care (“National Health Expenditure Fact Sheet”, n.d.). Transparency will help develop the needed information for a beneficial policy that will enhance the health care system. The use of transparency will show the stakeholders the importance and the need for the policy.

Recommendation Rationale

Transparency can be considered as the initial step in the process for a policy to set affordable drug prices. The verification of this transparent system will become apparent in the following outcomes:

Transparency in within pricing policies will ease the reluctance in the communities they serve, this concern comes from the silence of the organizations involved which can lead to conflict. The public’s concern can lead to uneasiness and tension throughout the process or within the health care system at the community level (Chantrill, n.d.).

With the help of transparency, the productivity within the medical field will be improved as well as the developments of the pricing decisions. A transparent practice will lead in consumer satisfaction and will bring quality in the products and services available to the public. Consumers will get proper guidance and care from seeking medical staff, this alleviates a significant amount of accusations and malpractice suits.

Transparency will also help in controlling the corruption among policy makers and organizations. At times the government requires money for medications that are supplied at little to no cost to the public that cannot afford them. This is the reason behind the price increase; however, the cost can become an issue for the public when confronted with the issue. This is the reason it is important for the health care system to be more transparent (Brennan, 2009).

Transparency is a positive decision because it assists in better living standards for the general public. When the costs of the health care services remain constant for a significant period of time and the prices remain reasonable factors in health care it is no longer a huge burden on the public (Chantrill, n.d.). It is observed that most of the revenues are being spent on individual’s health concerns, if this issue is resolved, then the public revenues can be used for better living circumstances or can go to the future of the family.

Timeline and Lifespan of Policy Plan

Transparency cannot be brought in all at one time, time is needed to bring a transparent arrangement into the health care system. For health care departments the transparency process can be started at the level of the production process. Corrective measures can be taken on a continuous basis this will enhance the credibility of the transparency. The duration will depend upon the outcomes of the initial steps in the process of the implementation of the transparency technique (Brennan, 2009). It can take two to three years to make the policy of transparency fully functional where full transparency is evident.

Placement within the Organization’s Existing Operations

Internally the transparency will be placed at operational level. The starting point will be directed by the corporate sector of the organization. This level needs to be transparent first and foremost and then the remaining departments can be directed accordingly (“OECD Health Statistics 2014: how Does the United States Compare?”, n.d.).

Provisions for Monitoring and Evaluation

Making policies is not a definitive solution to the problem of the increasing of the costs and drug prices. Transparency cannot be evolved by itself; it needs a comprehensive and critical evaluation process. The evaluation process should critically examine on a gradual basis. For an evaluation, it is suggested to set some standards before a comparative analysis. These standards will advise the optimum level needed to be achieved in terms of gaining transparency (“OECD Health Statistics 2014: how Does the United States Compare?” n.d.).

Conclusion

Health care providers in the United States remain a significant concern among stakeholders. The sector has faced a declining standard in the medical care provision leading to the development and implementation of the public policy plans. Once more, the efforts to introduce the policies have attracted mixed reactions from various participants in this sector, such as government, patients, insurance companies, and health information technology. Through Republicans, the Colorado State rejects the proposals of expanding Medicaid and providing insurance through the patient. Furthermore, the health care system in the United States faces significance levels of income inequalities hindering their ability to acquire quality health care. Additionally, poverty-related issues also affect the access to quality treatment since lower-income earners have a challenge of meeting the medical costs. Policy strategies help to determine the benefits, cost, and effectiveness of an implemented policy. Transparency is mainly centered on clients; they have opportunities to inquire about treatment costs and options.

Payment reforms are important since the cost of the healthcare was so high, medical bankruptcy has affected more than a million individuals. Increasing the medical cost risked taking up the federal government’s resources. Consideration of social determinants in healthcare is very important especially among the vulnerable populations. Factors such as the environment, education, and income are some of the crucial factors which are taken into consideration when providing the care. Therefore, maintaining the knowledge of how the healthcare system is progressing can make sure that the care people are receiving is effective and affordable.

Policy making is not an easy or rapid process it involves a number of technical aspects and a detailed planning process. Complete research that is developed based on comprehensive planning will provide a well-developed policy, however, without considering the bottom-line issues the real policies cannot be developed. Policy makers should have a complete knowledge of field and valid data to find the best solutions for the future. Employees should also be involved in the process of policy making, their involvement will enhance the credibility of the transparency process.

An informative announcement of the process that is being taken should be a step toward the process of fixing the prices. This statement will resolve the conflict between the clients and policy makers. The concern will be decreased among the public therefore, restoring the confidence in the policy and the policy makers.

References

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