Understanding Healthcare Policy: Navigating Change In Nursing Practice

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Anyone who works in the healthcare industry needs to understand the current policies and how they affect everyone. You should start by understanding healthcare policy is and why it matters. After that, we can look at some of the most recent changes and what we can expect in the future as new technology makes an ever-greater impact in the health sector.

What is healthcare policy?

There is not a single healthcare policy that we can point to as explaining everything you need to know about this. Instead, this term is used to cover the many laws and regulations present in the US healthcare system. It’s clearly a big subject, as it runs from the access people have to healthcare to the cost, the key security aspects, and the way that drugs are controlled, among other things.

Why does this matter? Well, if you’re working in any area of healthcare, you need to know the current rules and regulations so you can carry out your job to the highest possible level. Both the national and local laws are hugely important, and you’ll want to stay up-to-date with all the changes that have been introduced.

As for patients, they have the right to understand what options are available to them and what steps have been taken to ensure that healthcare providers look after them in a safe and responsible manner at all times. In this way, they can more easily identify any issues in the way they’re being treated and ask the right questions about how things are being done.

While only a limited number of people, such as policymakers and administrators, need to have a truly in-depth knowledge of every aspect of these policies, there are some basic facts that everyone should be aware of. As we’ll see in a moment, gaining an understanding of healthcare policies is also vital for anyone who plans to work in the health industry.

The basic facts

The starting point here is the fact that healthcare can be received in a few different ways in the US. The first is through one of the public programs, Medicaid or Medicare, with the former aimed at the lower-income population and the latter at anyone aged 65 or over, as well as younger people with certain health issues.

The majority of Americans get their healthcare covered through the other approach, which is private insurance. It can be arranged either through an employer or else by looking in the open market for private health insurance policies. Each of these methods needs to be controlled and administered in an appropriate way.

However, this summary of the basics leaves a lot of gaps that we need to cover. In such a huge and diverse subject, there is a need for extensive regulations that fill all the gaps and make everyone’s responsibilities clear. It is why there are so many healthcare policies that control the industry.

Without these policies, it would be impossible to manage the sector and ensure the correct level of care for everyone. However, it’s also important to note that these policies cover a number of areas and change over time as new laws and amendments are introduced to attempt to improve them for everyone’s benefit.

What are the key areas of healthcare policies?

You’re likely to see this subject split into four broad areas. The first is patient care policies. These are the processes and protocols that health workers need to stick to in each type of situation. They give patients and their families the comfort of knowing what will happen while also guiding healthcare workers through their workflows.

It’s easy to view patient care policies as the most important part of this subject, as it’s the point where healthcare employees look after the public. However, while this is a crucial subject, the other types of policies are just as important, even if they aren’t quite as visible for members of the public or as attention-grabbing when they’re in the news.

For example, employee health policies are designed to help employees in the sector look after patients while being confident that their own well-being is being taken into account at the same time. It includes the policies for wearing masks and gloves as well as the rules for using chemicals and other substances.

Without this, employees could find themselves working in unsafe conditions or unaware of their rights. Depending on the exact role that they carry out, this could be the most important area for a healthcare worker to fully understand.

Drug policies let us see how pharmaceuticals should be handled, delivered, and administered. They also look at situations such as what to do in the event of drugs going missing or being administered incorrectly. Again, in certain roles, this is the area of most concern that an employee might spend the majority of their time understanding and complying with.

The final area looks at security and privacy policies. It is where we can see how healthcare facilities need to handle any security threats, such as abusive patients or threats of violence. It also looks at the handling of data to keep patient information safe and highly protected at all times. While this might be a more pressing concern for administrative staff than for others, it’s an area everyone should know about to some degree.

How is healthcare changing?

Every new piece of legislation released in this area has an impact on the healthcare sector in one or more of the areas we just looked at. By looking back at some of the most important laws and amendments from the past, we can get a feel for what has changed and what might happen in the future.

The Social Security Amendments of 1965 are a good starting point for understanding healthcare policy in the US, as these are the laws that introduced both Medicare and Medicaid. Signed by President Lyndon B. Johnson and also known as the Medicare and Medicaid Act, it was generally well received, and it’s reported that up to 20 million people were enrolled in the first three years.

After that, another change came in 1973 with the Health Maintenance Organization Act of that year. It was an important piece of legislation that led to the development of a federal initiative designed to create alternative forms of healthcare delivery. Service plans called HMOs (health maintenance organizations) were the key to this plan as an alternative to the fee-for-service type of plan.

Fast forward to 1985, and we see the introduction of the Consolidated Omnibus Budget Reconciliation Act of 1985. This Act is commonly known as COBRA, and it was introduced to give workers and their family members the chance to continue with their health benefits in situations when they would otherwise lose them, such as when they suffer the loss of a job.

In 1996, the Health Insurance Portability and Accountability Act brought about an important change, as it was designed to modernize the way information is used in the healthcare sector. Signed by President Bill Clinton, it explained how personally identifiable information has to be handled to avoid issues such as identity theft and fraud.

The Patient Protection and Affordable Care Act of 2010 is another recent example. Commonly known as Obamacare since it was signed by then-President Barack Obama, this piece of legislation was created to make it easier for more people to obtain affordable health insurance, with premium tax credits being one way of doing this.

By looking at these changes, we can more fully understand the role played by healthcare policies. Each of them has provided a clear way forward designed to resolve existing issues and improve the healthcare sector in one way or another. You might not always agree with the changes that are brought in, but there’s no doubt that the clarity provided by these policies is essential to the smooth running of the industry.

What does someone looking to work in the healthcare industry need to know?

Whether you plan to work as a nurse, a doctor, an administrator, or in some other area of the industry, it’s important that you understand the basics of healthcare policies that we look at. Naturally, each person needs to find out about the specific areas that are most relevant to their role, as well as having a good general understanding of the overall subject.

In terms of anyone who is planning to join the industry, an Online Masters in Nursing Leadership offered by reputable institutions, such as the University of Indianapolis, includes all of the essential subjects needed for a newcomer, such as population health and informatics, alongside management topics such as leadership and management for nurse executives. Expect to learn about the current policies as well as the major issues that you’ll come across in the workplace, with regulatory issues and healthcare economics among the important issues covered.

Staying up-to-date on these issues is of huge importance for anyone who is already working in a healthcare role and should be taken care of during ongoing training sessions to update their knowledge and working practices.

Failing to comply with any of the current policies would be a serious matter that could result in disciplinary issues as well as putting at risk the health of the employee and their patients. It is why staying up-to-date with the latest changes is something that can’t be taken lightly.

What does the future hold?

The subject of healthcare has long been a source of debate, and that isn’t likely to change any time soon, with many people pushing for new laws that improve what they perceive to be weaknesses or flaws in the current system.

The idea of a national health program that’s free for everyone to use is one of the longest-running debates in American political history, and there are no signs that it will be resolved in the near future. However, this is a constantly changing landscape, and we see new changes introduced that attempt to improve everyone’s healthcare possibilities.

A look at recent news stories reveals that people on all sides of the debate and of all political opinions are always looking to introduce the changes that they believe are necessary for a better future. There are no major updates to the current policies on the horizon at the time of this writing. Yet, this is a subject that can very quickly change as a new need is identified or a smarter way of working is introduced to try and make the processes better and more efficient.

The cost and coverage of healthcare are always going to be the main areas of concern and those that capture the attention of the public most easily. Yet, there are many other aspects of healthcare policies that aren’t as high-profile but are also hugely important.

Cutting-edge technology is one of the areas of most interest right now, and there’s no doubt that the likes of artificial intelligence, the blockchain, and the metaverse are among the technologies that could have a huge impact on healthcare in the next few years.

It is going to open up a lot of exciting new possibilities for providing better and faster healthcare, but it will also lead to questions being asked about the validity and usefulness of the current policies as new risks emerge.

Healthcare policies will keep changing

A look back at previous healthcare policy amendments earlier showed that they tend to change at a fairly slow pace. It’s not unusual to see a decade or more pass without any major updates to the laws.However, the types of emerging technology mentioned above could lead to more rapid changes in the near future as the authorities are forced to act on the opportunities and threats posed by new technology.

Regardless of what happens in this respect, everyone who works in the healthcare industry or is interested in getting a role in it has an obligation to understand the current policies and how they can meet them in their day-to-day duties.

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The chief editor here at Billboard Health, wife and Mother of 1, Nutritionist and goal getter.

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