Presentation on Ethical and Policy Factors in Care Coordination

Ethical and Policy Factors in Care Coordination

Over the past decade, successive administrations have consistently attempted  to improve access to affordable and reliable healthcare services as a possible solution to the healthcare disparities currently witnessed in the United States. A recent report published in the Compendium of Federal Data-sets concluded that healthcare disparities remain some of the most relevant issues in healthcare today (Flescher, 2021). This is mainly because it affects a diverse group of vulnerable individuals and with accompanying implications capable of review based determinants such as race, gender, ethnicity, and sexual orientation. Today, public health initiatives such as Healthy People 2020 are instrumental in highlighting the impact of government policies related to health and community safety impact the coordination of care.

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Care Coordination and emerging Policy Factors

Care coordination is an integral aspect of the current formulation of the healthcare system and typically entails the deliberate organization of relevant care activities by healthcare providers. This process may also include additional activities requiring the direct involvement, such as patient education, and emergency services for families chief among them being group therapy. Further, care coordination also involves the collaboration of an accredited team of healthcare providers with a wide array of standard resources required when seeking to provide much-needed care services (Amos, 2022). Any policy change made within the healthcare sector is, therefore, highly likely to have a major impact on patient safety and the subsequent attainment of set treatment goals.

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 Policies changes such as those contained in the Affordable Care Act (ACA) had a considerable impact on healthcare. It expanded access to healthcare insurance to vulnerable groups such as ethnic minorities and senior citizens while also playing a major role in the overall improvement of care coordination. Policy changes introduced by the ACA had a significant impact on the healthcare system and the provision of much-needed services by provides given that institutions were required to adhere to binding regulations while being required to observe set policy rules.

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Governmental Policies associated with Community Health and Safety and Impact on Care Coordination

The Health Insurance Portability and Accountability Act (HIPPA)

The recent emergence and integration of state-of-the-art technology has long been a relevant cause of concern for healthcare providers and pundits due to the risk of unauthorized access of patient data. Such concerns were among the main reasons why HIPAA was introduced in mid-1996 to ensure that national regulations now existed for the protection of confidential patient data. HIPAA also introduced a Protected Health Information (PHI) clause as standard protocol in healthcare organizations to guarantee patient safety while ensuring that electronic health records (EHRs) are only accessed by authorized personnel (Jones, 2019). Yet, it is crucial to also remember that HIPAA has its limitations. According to Vrijhoef (2021), HIPAA rules and regulations may actually hinder proper patient-doctor communication and may impede efforts targeting high-quality care. This policy change has also been criticized by its detractors for not providing a viable operational framework to ensure healthcare providers are fully conversant with standard rules set by HIPPA’s core principles.

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MEDICAID

Policy makers, under the auspices of the HHS, currently play a critical role in the drafting and proposition of new policies seeking to improve the present formulation of the healthcare system in the US. Novel changes such as those introduced by the MEDICAID have, thus, been instrumental in addressing healthcare disparities by focusing on pertinent issues such as mental health and access to care among the disabled. The core principles of policy changes such as MEDICAID have played a critical role in care coordination and are currently linked to an overall improvement in patient experience during care. It is now apparent that policy changes seek to aid both patients and care providers to navigate complex clinical scenarios. Moreover, new policies such as those introduced by MEDICAID specifically focus on value-addition and the introduction of perks such as cost reduction while avoiding service duplication.

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Local Policy Provisions Raising Ethical Questions

A thorough evaluation of the main ethical dilemmas plaguing care coordination is also necessary when attempting to gain an unadulterated perspective of the present state of care coordination. Healthcare professionals, particularly those practicing in the US, have recently noted a sharp rise in ethical dilemmas in their day-to-day endeavors. One of the most serious ethical issues facing healthcare professionals today is whether or not to treat patients without cover. Additionally, many are also left debating the choices made when deciding on the most appropriate formula to follow when selecting candidates for subsidized care. Discussions on expenditure on drugs for patients with medical insurance coverage has also raised pertinent ethical questions and have even prompted calls for the introduction of annual revisions to evaluate the complexity of plans made.

Implications of the Code of Ethics on the Continuum of Care among Nurses

Healthcare agencies and their constituents, such as Healthy People 2020, play an important role in evaluating social determinants affecting healthcare in a coordinated attempt geared towards improving the clinical environment. This process has often involved the accurate identification of relevant measures likely to improve the quality of the environment in which healthcare professionals are expected to practice. Nurses are at the front-line of this phenomenon since they possess invaluable clinical skills and are able to identify specific social determinants likely to influence equity in health (Sturgill et al., 2019). They, therefore, plat an active role in assessing the social effects of policy changes such as those introduced by the ACA in healthcare in relation to possible implications for model development. These concerns have been addressed through the introduction of care coordination protocols for an ailing healthcare sector while focusing on the ever-growing list patient’s care needs.

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Summary of Ethical Policy Issues Impacting Patients

Ethical policy issues, such as those experienced as a consequence of the ACA, have a significant effect on care coordination particularly among vulnerable populations such as children with disabilities and seniors in nursing homes. The ethical policy questions encountered in such environments now constitute ethical policy issues that influence positive changes based on a framework focusing on pertinent policy issues. This reality also has a direct impact on the overall continuum of care coordination and can be linked to emerging challenges such as the shortage of staff, significant increase in readmission rates, and a general failure to address patient’s concerns. Policy changes should, therefore, be drafted with the concerns of both patients and clinical staff in mind to guarantee the provision of top-tier efficient healthcare services embracing core principles of care coordination.

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