Posted: October 3rd, 2024

Nursing Leadership Health Policy Essay

Nursing Leadership Health Policy Essay.

Medicare is one of the biggest providers of healthcare funding in the United States, and covers around half the health costs of almost 60 million people (Mason, Leavitt, & Chaffee, 2013). This significant coverage highlights the importance of Medicare in the US healthcare system. Despite this, the original 1965 Medicare legislation contains anti-discrimination text that means that often, the nuances of health conditions are not covered (Mason et al., 2013). This limitation can lead to inadequate coverage for individuals with chronic conditions, such as diabetes.

Despite this, regular eye tests are recommended for individuals with diabetes and is part of living with this chronic condition, meaning that Medicare is not providing the essential services that it needs due to a lack of nuance in the wording (Mason et al., 2013). Furthermore, this lack of coverage can result in increased healthcare costs for individuals with diabetes. Diabetics currently have to pay 20% of the cost of these eye exams and in a hospital setting are liable for a copayment (Mason et al., 2013). This financial burden can be significant for individuals with limited financial resources.

The purpose of this paper is to explore a policy change designed to improve the specificity of Medicare for those with long-term health conditions. This policy change aims to address the limitations of the current Medicare system and provide more comprehensive coverage for individuals with chronic conditions.

The House of Representatives have recently passed a bill that helps Medicare to provide more clinically nuanced benefit systems in the Medicare Advantage Program (Mason et al., 2013). This bill is a step in the right direction, but more needs to be done to address the complexities of chronic conditions. This is due to the fact that anti-discrimination laws written into the original Medicare protocol do not allow for nuance in coverage (Mason et al., 2013). As a result, individuals with chronic conditions may not receive the necessary care and services.

Despite this, there is still room for improvement in terms of improving the nuance of Medicare to ensure that people are getting the services that they need. One potential solution is to allow for more flexibility in the development of Medicare protocol for individuals with long-term conditions. Diabetics, for example, now have some elements of a yearly eye test for glaucoma covered, but still have to pay a copayment in some scenarios (medicare.org, 2016). However, this coverage is still limited and does not address the full range of eye care needs for individuals with diabetes.

Physicians may also recommend that a diabetic patient gets eye tests more regularly than yearly, or other eye-related testing, which is not covered by Medicare despite the fact that diabetes is a chronic condition (mediare.org, 2016). This lack of coverage can result in delayed diagnosis and treatment of eye-related complications. The proposed change is to allow for more nuance in the development of Medicare protocol in terms of long-term conditions.

Chapter 4 of the Medicare provision bill currently contains a passage that aims to prevent discrimination. However, this passage also limits the ability of Medicare to provide nuanced coverage for individuals with chronic conditions. The current wording of this passage aims to prevent discrimination, but the proposed change would allow for discrimination on the basis of providing more nuanced healthcare. This change would enable Medicare to provide more targeted and effective care for individuals with chronic conditions.

The proposed change would include an additional clause that would allow for discrimination based on the better provision of health services to those that fulfill the above criteria. This clause would provide more flexibility in the development of Medicare protocol and enable more comprehensive coverage for individuals with chronic conditions. The change would be worded as follows:
“Discrimination based on the above factors with the aim of specifically providing better services to those that fall into these categories is accepted. The provision of eye tests to those with long-term conditions that require additional monitoring is allowed, as is promotion of health services that can benefit marginalized populations.”

The first step of implementation is to research countries that have full healthcare coverage, like the United Kingdom. This research can provide valuable insights into how to develop a more comprehensive and nuanced healthcare system. Understanding how the National Health Service bills are worded can help to understand what type of information needs to be provided in order to make Medicare work more efficiently in the United States. Additionally, this research can inform the development of more effective healthcare policies and protocols.

The second step is lobbying for change. Nurses need to be involved in the political process and understand who needs to be approached in order to get this additional passage added to the Medicare bill. It will be useful to know who is most likely to support better coverage for the marginalized under Medicare and use this individual as a public advocate for the proposed change. Building relationships with key stakeholders and policymakers is crucial for successful lobbying.

This can also involve researching the different levels of care in different states to assess how the change would work on a national/federal level. It can also be useful to understand which parts of the bill will be affected through the change. The final stage is preparing hospital staff for the change after it has been passed. This involves training on Medicare provision and how the change is going to affect incoming payments from Medicare patient. Effective communication and training are essential for a smooth transition.

Billing departments need to be notified in order for the bill to work successfully in real-life scenarios. Clear guidelines and protocols need to be established to ensure accurate billing and reimbursement. The two main advocates for this change are likely to be federal legislators, who need to understand the proposed change and make economic concessions for how the bill will affect national finances and provision of Medicare (Mason et al., 2013). These individuals need to lobby for the change in the Senate to ensure that it is passed in an appropriate manner.

The second main advocate is national state nursing organizations, who are likely to support the change in that it will provide better services that are appropriate for those who have certain life-long conditions and need extra care to be covered by Medicare. These organizations can provide valuable input and expertise in the development of healthcare policies and protocols. These organizations will be influential in making changes occur. I have not voted for the individual in office that will be responsible for making the change, but lobbying is still an option. It will be interesting to see how national nursing organizations approach the change.

Order | Check Discount

Tags: Chronic Conditions, Health insurance reform, Healthcare Policy, Medicare, Nursing Leadership