Policy, Politics And Global Trends Essay

7572 words - 31 pages

Barbara Heard
MSN 285637
Mentor: Ronda Arnold
March 15, 2015


This assignment requires that I develop and thoroughly analyze a public policy in order to advocate for one that improves the health of the public and/or the nursing profession globally (local, state, national or international). To do this, I must reflect on several aspects of being a policy maker within the nursing profession. I was instructed to consider the following:
· Why did I select the health or nursing profession policy issue?
· How does this issue affect nursing practice, healthcare delivery and ...view middle of the document...

· Bottom-up approach /community based participatory approach – one in which those who are impacted by the issue, usually the stakeholders collaborate to design interventions, rather than being told what to do by formal policy.
· Policy – the deliberate course of action chosen by an individual or group in order to deal with a specific problem or issue.
o Public policies are choices made by government officials to deal with public policy (Policy & Politics in Nursing & Health Care, 6th edition)
· Stakeholder – person, group or organization that has interest or concern in an organization (businessdictionary)
· Pay-for-performance payment model – healthcare payment systems that offer financial rewards to providers who achieve, improve or excel their performance on specified quality of care and cost measures (HealthCare Incentives Improvement Institute, N.D.)

In Public Policy Issue:
The policy issue that I have selected to discuss herein is the pay-for-performance payment model. I feel that this impacts a large number of our population and changes in this regard should be made. This type of payment model aims to use reimbursement to incentivize providers to deliver high quality services. Pay-for-performance model steps away from the traditional manner of reimbursement of fee-for-service, in which providers receive payment on the basis of frequency or volume of the services they provide regardless of outcomes. In contrast, pay-for-performance reimbursement is associated with specific outcome based measures, to include care processes, patient outcomes, patient experience and resource use. In regard to incentives, they should be twofold and aimed at creating an environment promoting both, patient well being and financial stability for physicians and healthcare institutions. In reviewing the pay-for-performance model, it appears that this is primarily beneficial only to physicians in terms of monetary incentives and the patient population has little to gain in relation to this manner of reimbursement for healthcare services. It is understood that the primary goal of this model places emphasis on value and an overall better quality of health care; however, there are mixed reviews in regards to this model improving health outcomes and reducing costs.
Issue Selection:
I selected this issue because I feel that this policy does not promote or support the values that health care is premised upon or the values that nursing represents and is of no benefit to the patient population. The policy primarily focuses on rewarding physicians financially in relation to reducing costs and specific quality outcomes based on particular measures. In this regard, it is my opinion that rewarding “good physicians” has the potential of diverting attention and possibly resources from “less successful”, but quite effective, physicians who serve less advantaged patients for whom quality improvement may be very critical. I also feel that incentives for...

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