2 questions, 2 references each at minimum 250 words
1. Discuss a barrier to health care delivery resulting from state or federal policy or the law. What changes might you recommend to the policy/law, and what positive or negative impact might you anticipate on patient care?
2. Identify a nurse serving on a state, regional, or national board, within or outside health care. Describe the membership and mission/vision of the board. Provide background on the nurse’s preparation and qualifications for sitting on the board. How does this particular nurse holding a seat benefit the board?
Expert Solution Preview
1. Barrier to Health Care Delivery Resulting from State or Federal Policy or Law:
Introduction:
The Healthcare system of the United States is heavily regulated by state and federal governments. Policies and laws imposed by these regulatory bodies have a significant impact on the delivery of healthcare. The financial implications of these policies, coupled with legal requirements, act as barriers to access and delivery of care. This essay discusses one such barrier.
Barriers to Health Care Delivery:
The Affordable Care Act (ACA) introduced the medical loss ratio (MLR) provision that requires insurance companies to use at least 80% of their overall premium revenue on patient care instead of administrative expenses or profits. This policy has led to a significant decrease in insurance providers’ profitability, with insurers reporting losses, particularly in smaller healthcare markets. As a result, insurance companies have been hesitant to expand coverage in smaller markets, impacting access to care for vulnerable patient populations.
Another barrier encountered in healthcare delivery is the increasing legal requirements for healthcare facilities, which are often expensive and can lead to a decline in the quality of healthcare. For instance, healthcare providers who are bound by legal requirements to report specific conditions have found that some patients avoid receiving care, which has slowed their ability to detect and treat these conditions.
Recommended Changes:
One solution to overcome the medical loss ratio provision’s challenge could be the introduction of an incentivized system whereby insurance providers are offered rewards or financial benefits for servicing these smaller, less profitable markets. In addition, investing in new insurer technologies to minimize administrative costs, particularly the cost of claims processing and billing, could provide a partial remedy.
Anticipated Impact:
If the above changes were implemented, there could be an improvement in healthcare access and delivery for specific population groups. New healthcare providers might be willing to enter smaller markets, and established providers could expand services. However, the negative impact would be a decrease in insurance providers’ profitability and difficulty in ensuring compliance with legal requirements enacted.
2. Identifying a Nurse Serving on a State, Regional, or National Board, within or outside Healthcare:
Introduction:
Nurses play a crucial role in ensuring efficient and effective healthcare delivery. Nurses who serve on boards within and outside healthcare organizations promote patient care and ensure that the views of those who deliver treatment are incorporated into policy formation.
Nurse Serving on a Board:
Jeannette Rodriguez is a registered nurse and serves on the National Association of Hispanic Nurses International Board of Directors. The National Association of Hispanic Nurses (NAHN) has a mission to seek better health for Hispanic patients by using nurse leadership to reinforce education, research, and advocacy. Rodriguez is responsible for ensuring the mission and vision of this organization are carried out.
Preparation and Qualifications:
Rodriguez worked for over two decades in healthcare, with a substantial portion dedicated to serving Hispanic populations. She obtained a Bachelor of Science in Nursing from Florida International University and a Master of Science in Nursing from Barry University. She also pursued Doctor of Philosophy in Nursing from Florida International University.
Benefits of a Nurse Serving on a Board:
Rodriguez’s sitting on the National Association of Hispanic Nurses International Board of Directors provides the board access to expert views from the nursing industry. Through her experience, skills, and knowledge, Rodriguez ensures the board mandates are professionally executed, ensuring shared success in achieving the organization’s goals. Furthermore, her background as a Spanish-speaking nurse and community health expert promotes NAHN’s outreach and fosters collaboration with other organizations that serve Hispanic populations. Overall, having a nurse like Jeannette Rodriguez serving on a board helps to ensure that nursing professionals’ preferences and concerns are included in policy formation.
