Medicaid expansion under the ACA has affected millions of Americans and particularly those in the under-served areas. Since RNs and APRNs are the ones directly involved in the delivery of care in the clinical setting, they are in a better position to assess the practicality of this policy and make recommendations for its improvement in the future. This article explains how nurses can take up the policy evaluation role with confidence and bring their clinical expertise to bear on large-scale healthcare improvement.
Understand the Basics of Policy Evaluation
To embark on the policy evaluation, the nurses need to understand what evaluation is all about. Policy evaluation is the process of determining whether a health policy is effective in delivering the intended goals, areas of success/failure and to inform the policy makers about the successes and failures of the policy. For the Medicaid expansion policy, the areas to be assessed are: access to primary care, the decrease in the rate of emergency department visits, the improvement of health outcomes and financial risk protection for the low-income population.
First, data collection can be done from your own practice or facility, and the following steps will be followed. Has there been an improvement in the consistency of patient’s access to care? Has there been a reduction on hospitalization that could have been avoided? Nurses can gather both qualitative and quantitative data from patients’ files, clinic sheets, or population data. These are good points, especially if they are accompanied by examples that make the use of numbers more tangible.
Also, it is important that you learn about the indicators used at the community, state or federal level. The usual measures used in Medicaid program evaluations include insurance coverage, utilization of preventive services, and cost outcomes. Having such benchmarks in mind helps nurses to present their discoveries in terms that policymakers will appreciate.
Link It Up with Social Determinants of Health
Therefore, for the nurse to be able to fully assess Medicaid expansion, s/he has to consider the SDOH that impacts on the patient. These are the income status, education, employment, housing, food security, and transport. Despite this, many patients still experience inadequate and irregular care because of these factors.
The nurses themselves are in the best position to see how these issues impact patients on a daily basis. For instance, a patient who is on Medicaid may still fail to attend a scheduled appointment due to poor transportation means. A may have unstable housing and cannot afford to buy or rent a house to store his/her medicines or even adhere to prescribed dosage regimens. Nurses can determine whether the policy is sufficiently addressing or, at least, providing for those barriers.
Writing about these issues can be helpful in order to get more resources such as telemedicine, mobile clinics, or more funding for social work. In this way, nurses are in a position to influence changes that enhance the policy’s effectiveness and its impact on different social groups.
Engage in the Policy Conversation
Policy evaluation is not only for policymakers and researchers, but it is a great advocacy tool for the nurses. After getting the insights, the next step is to disseminate them to the relevant stakeholders. This can be done through official bodies such as committees, community health organizations, or the hospital management. Nurses can also write policy briefs or participate in the public hearings where health care policies are being debated on.
If you are still unsure, it is better to begin with something minor. The following are recommendations that the student should consider in order to meet the above learning outcomes: These groups may offer support, education or ways for the nurse to become involved without having to commit a lot of time. By these forums, the nurses can get to know other people who are also interested in policy evaluation and also how to present the findings.
Another effective method of dissemination of your evaluation is through legislative visits or by writing to your state legislators. Real-life examples are always convincing when they are supported by medical practice. When one hears policy in practice from professional practitioners such as nurses, then policymakers are more likely to consider policy changes.
It is not necessary for a nurse to be a policy expert in order to engage in policy evaluation; they only have to begin where they are. Medicaid expansion is one of the healthcare policies that has impacted many patients in the United States. Thus, the proposed approach allows RNs and APRNs to make a significant contribution to the development of more effective healthcare systems by evaluating the actual effect and gaps related to social determinants. It is time to act and the voice of the nurse has never been more important.
Related Questions
The Role of the RN/APRN in Policy Evaluation
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare:
In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
Review the Resources and reflect on the role of professional nurses in policy evaluation.
By Day 3 of Week 9
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.
By Day 6 of Week 9
Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
Note: Throughout this program, your fellow students are referred to as colleagues.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
