Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve.
Healthcare program/policy evaluation analysis
Program policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.
Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.
- Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
- Select an existing healthcare program or policy evaluation or choose one of interest to you and get approval to use it from your Instructor.
- Review the healthcare program or policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
- Describe the healthcare program or policy outcomes.
- How was the success of the program or policy measured?
- How many people were reached by the program or policy selected?
- How much of an impact was realized with the program or policy selected?
- At what point in program implementation was the program or policy evaluation conducted?
- What data was used to conduct the program or policy evaluation?
- What specific information on unintended consequences was identified?
- 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.
- Did the program or policy meet the original intent and objectives? Why or why not?
- Would you recommend implementing this program or policy in your place of work? Why or why not?
- Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
Expert Answer and Explanation
Healthcare Program/Policy Evaluation Analysis Template
Advanced practice nurses need to actively participate in policymaking as part of their advocacy role to better health care delivery. To do so, we need to know how to analyze and understand different health care policies and their impact in creating change (Milstead & Short, 2019).
Health care policies in one way or another affect how we deliver patient care, and without our input in policymaking, we are likely to receive the short end of the stick. In this analysis paper, I will be reviewing one of the health care policies that have significantly transformed how we provide care to patients.
|Healthcare Program/Policy Evaluation||
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
|Description||MACRA is a health care policy signed into law in 2015 by former President Barack Obama. The act completely repealed the Medicare sustainable growth rate and transformed the reimbursement model from a fee-for-service approach to a value-based model by introducing the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). Overall, MACRA has been cited as one of the most transformative pieces of legislation that touches on the quality of patient care.|
|How was the success of the program or policy measured?||The success of MACRA was measured mainly by evaluating its impact on patient quality and cost of care.|
|How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?||The policy affects both providers and millions of Americans eligible for Medicare on or after 2020.
So far, according to Centers for Medicare and Medicaid Services (CMS), over 1 million clinicians participated in MACRA’s quality payment program as of 2017, with over 90%of the participants receiving a positive payment adjustment noting that the act has made some positive impact in provider reimbursements (Gdiesing, 2018). Cheng et al. (2020) in their paper also note an improvement in cost-savings as a result of quality improvement in the provision of care. Given that the policy is, barely six years old, its long-term impact on sustained quality of care is yet to be established.
|At what point in program implementation was the program or policy evaluation conducted?||The first comprehensive evaluation of the program was done post-implementation by CMS, while other independent research entities did other parallel evaluations albeit narrower in scope.|
|What data was used to conduct the program or policy evaluation?||Data on health care reimbursements for physicians was used in the evaluation to assess whether there was a positive impact in adherence to quality standards|
|What specific information on unintended consequences was identified?||Some of the critics argued that the change in reimbursement models would result in a reduction in reimbursement, which has proved not to be the case. The evaluation statistics show an improvement in provider reimbursements.|
|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.||The main stakeholders identified in the evaluation by CMS are physicians. Physicians who are yet to join the quality reimbursement program and patients will be the largest beneficiaries of this information. The data which shows a positive trajectory in hospital reimbursements for physicians and the attached quality of care will make the two interested in the findings from the policy evaluation.|
|Did the program or policy meet the original intent and objectives? Why or why not?||While the policy is still at its infant stages, the first review by the CMS shows a positive impact on physician reimbursement and to some extent quality of care. Future evaluations will provide more detailed information on the impact on cost and quality of patient care.|
|Would you recommend implementing this program or policy in your place of work? Why or why not?||The value-based payment model as introduced by MACRA, despite the underlying challenges is a good policy to start with, which emphasizes patient quality. The policy as is can still be implemented to guide quality improvement and reimbursements of efforts to improve patient care within health care institutions.|
|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.||As a nurse advocate, I play a significant role in policy evaluation, with the first role being to scrutinize data on the immediate impact of the policy on patient outcomes and match it with what was the intended impact of the policy. We also have a role to play in providing useful information to relevant bodies on the performance of the policy and the overall impact on providers and the population.|
|General Notes/Comments||MACRA is still fairly new legislation with results from preliminary evaluation showing a positive impact on provider reimbursements. Future evaluations are expected to paint a clear picture of whether the intended change in quality was achieved or not.|
While MACRA is still a fairly new policy, the results collected from the first evaluation indicate a positive outlook in terms of provider reimbursements. This leads to the conclusion that improving the quality of care using the value-based model has a better return for physicians in terms of reimbursements compared to the fee-for-service approach.
Cheng, J., Kim, J., Bieber, S. D., & Lin, E. (2020). Four years into MACRA: What has changed?. Seminars in dialysis, 33(1), 26–34. https://doi.org/10.1111/sdi.12852
Gdiesing. (2018). CMS releases performance results for year one of MACRA QPP: AHA News. American Hospital Association | AHA News. https://www.aha.org/news/headline/2018-11-08-cms-releases-performance-results-year-one-macra-qpp.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning
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Healthcare program or policy evaluation examples
Here are some examples of healthcare program or policy evaluations:
- Medicaid Expansion: The evaluation of the Medicaid Expansion program can examine the effects of increased access to healthcare services, including improvements in health outcomes and cost savings for individuals and states.
- Hospital Quality Improvement Programs: The evaluation of hospital quality improvement programs can assess the impact of these programs on patient outcomes, such as reductions in hospital-acquired infections and readmission rates.
- Mental Health Parity Laws: The evaluation of mental health parity laws can examine the impact of these policies on access to mental health services and health outcomes for individuals with mental health conditions.
- Chronic Disease Management Programs: The evaluation of chronic disease management programs can assess the effectiveness of interventions aimed at improving the management of chronic conditions, such as diabetes or hypertension.
- Telemedicine Programs: The evaluation of telemedicine programs can assess the impact of virtual healthcare services on patient outcomes, such as access to care, satisfaction, and health outcomes.
- Health Information Exchange (HIE): The evaluation of health information exchange systems can examine the impact of these systems on care coordination, quality, and efficiency, as well as patient outcomes.
- Health Promotion and Disease Prevention Programs: The evaluation of health promotion and disease prevention programs can assess the effectiveness of interventions aimed at improving health behaviors, reducing risk factors, and preventing the onset of chronic diseases.
- Patient-Centered Medical Home (PCMH) Models: The evaluation of PCMH models can examine the impact of these models on patient outcomes, such as improvements in care coordination, quality, and efficiency, as well as patient satisfaction.
Examples of healthcare programs
Here are some examples of healthcare programs:
- Immunization Programs: Immunization programs are designed to provide vaccines to prevent infectious diseases such as measles, mumps, rubella, and polio.
- Maternal and Child Health Programs: Maternal and child health programs provide care and support to pregnant women, infants, and children to ensure they receive adequate health care and nutritional support.
- HIV/AIDS Programs: HIV/AIDS programs offer prevention education, testing, treatment, and support for individuals infected with HIV and those at risk of infection.
- Cancer Screening Programs: Cancer screening programs offer early detection services for cancer, such as mammograms for breast cancer or colonoscopies for colon cancer.
- Mental Health Programs: Mental health programs offer counseling, support, and treatment services for individuals with mental health disorders such as depression, anxiety, or bipolar disorder.
- Substance Abuse Programs: Substance abuse programs offer treatment and support for individuals dealing with addiction to drugs or alcohol.
- Community Health Centers: Community health centers provide affordable, primary care services to individuals and families in underserved or low-income communities.
- Telemedicine Programs: Telemedicine programs offer virtual healthcare services, including consultations, diagnoses, and treatment, for individuals who cannot physically access traditional healthcare services.
- Chronic Disease Management Programs: Chronic disease management programs provide education, support, and treatment services for individuals living with chronic conditions such as diabetes, hypertension, or heart disease.
- Health Promotion and Disease Prevention Programs: Health promotion and disease prevention programs offer education and resources to encourage healthy behaviors and prevent the onset of chronic diseases.