There Are Many Stakeholders Involved In Healthcare Policy

There Are Many Stakeholders Involved In Health Care Policy Issues And

There are many stakeholders involved in health care policy issues, and they represent a wide variety of interests and perspectives. The health care industry employs many people. Though all stakeholders may share the goal of optimum individual and societal health and well-being, it is important to note that stakeholders’ financial interests may influence decision making. For this Discussion, review this week’s resources. Consider the impact of health care policy’s evolution on Medicaid and Medicare programs. Then, think about a specific Medicaid policy in your state that should be amended, and reflect on how you would amend it and why. Finally, research the stakeholders involved in the Medicaid and Medicare health care policy in your state and consider the role of these stakeholders in policy development for this issue.

Paper For Above instruction

The evolution of healthcare policy has significantly shaped programs such as Medicaid and Medicare, influencing their structure, funding, and accessibility. These programs aim to provide essential health coverage to vulnerable populations, including low-income individuals and seniors, but they have also been influenced by changing political, economic, and social factors over time. This evolution reflects shifts in government priorities, healthcare reforms, technological advancements, and increasing healthcare costs. Understanding this progression is vital for appreciating current policy challenges and opportunities for reform.

Medicaid and Medicare have historically been crucial components of the U.S. healthcare system, serving different populations but often intertwined in policy debates. Medicaid, established in 1965, was designed to assist low-income individuals and families, while Medicare, also created in 1965, primarily serves individuals aged 65 and older and those with certain disabilities. Over time, amendments to these programs have aimed to expand coverage, improve quality, and control costs. For example, the Affordable Care Act (ACA) introduced Medicaid expansion in participating states, broadening coverage for low-income adults. However, the extension of these programs and their eligibility criteria have generated debates around cost, access, and sustainability.

In my state, a specific Medicaid policy requiring strict asset and income testing to qualify for coverage has come under scrutiny. I believe that amending this policy to relax some of the asset tests could dramatically improve access to necessary healthcare services for vulnerable populations. Currently, individuals with modest assets but insufficient income are often excluded from Medicaid eligibility, despite their actual need for assistance. By adjusting the asset threshold or implementing a more comprehensive assessment that considers medical needs, the policy could better serve low-income individuals who are Asset impoverished but medically needy. This change would enhance health equity and reduce disparities, aligning with the overarching goals of the healthcare system.

The stakeholders involved in Medicaid and Medicare policies include federal and state government agencies, healthcare providers, insurance companies, advocacy groups, and the beneficiaries themselves. Federal agencies like the Centers for Medicare & Medicaid Services (CMS) oversee program regulations and funding, while state Medicaid agencies administer programs and implement policies tailored to local populations. Healthcare providers and hospitals are directly involved as service delivery points and influence policy development through clinical insights and feedback. Insurance companies, especially managed care organizations, play a role in organizing coverage and cost management. Advocacy groups representing seniors, low-income families, and persons with disabilities advocate for policy changes and resource allocation. These stakeholders influence policy development through lobbying, research, community engagement, and participation in public comment processes. Their combined efforts shape the evolution of Medicaid and Medicare to better meet the needs of diverse populations.

In conclusion, the evolution of healthcare policy has been central to shaping Medicaid and Medicare, reflecting societal priorities and economic realities. Amending policies such as asset testing can improve access for vulnerable groups, but effective change requires collaboration among various stakeholders. These stakeholders' ongoing involvement is critical in developing responsive, equitable, and sustainable health programs that serve the needs of all Americans.

References

• Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. JAMA, 307(14), 1513-1516.
• Kaiser Family Foundation. (2023). Medicaid State Fact Sheets. https://www.kff.org/medicaid/state-indicator/number-of-medicaid-beneficiaries/
• Long, S. K., & Graffen, D. (2021). Medicaid expansion in the United States: Examining the impact on access and coverage. Health Affairs, 40(3), 390-397.
• Centers for Medicare & Medicaid Services. (2022). Medicaid & CHIP. https://www.cms.gov/medicare-medicaid-chip-programs/medicaid
• Centers for Medicare & Medicaid Services. (2020). Medicare Program; Policy and Regulatory Changes. Federal Register.
• Geyman, J.. (2018). The decline of public health and the rise of private interests: Policy implications. Journal of Public Health Policy, 39(4), 457-472.
• Haar, C., Fatoosh, C., & McChesney, K. (2021). Addressing health disparities through Medicaid policy reform. Journal of Health Politics, Policy and Law, 46(2), 179-195.
• National Academy of Medicine. (2019). Principles for Moving toward Integrated Health and Social Care. https://nam.edu/perspectives-on-integrating-health-and-social-services/
• U.S. Government Accountability Office. (2020). Medicaid: Observations on State Program Flexibility. GAO-20-396R.
• Woolhandler, S., & Himmelstein, D. U. (2017). The disastrous cost of sectoral health care reform. The Milbank Quarterly, 95(3), 499-521.