Across the nation, healthcare policies affect nearly every aspect of patient care and the professionals who provide it. Specifically, healthcare policies refer to the laws and regulations that impact how care is provided in different facilities, including hospitals, physicians’ offices, and other medical practices.
Whether you have plans to go into healthcare or healthcare administration, understanding how these policies are implemented and the impact they have on the field is important.
Understanding Healthcare Policies: A Brief Overview
Healthcare policies can and do change on a regular basis in the dynamic healthcare field, which is why it’s so important for providers and administrators alike to always remain up to date.
The Essential Role of Healthcare Policies
There’s no denying that healthcare policies play an essential and direct role in patient care across all healthcare settings. This is because healthcare policies set guidelines for anything from how patients receive care to the protocols providers must follow when rendering medical care. Some healthcare policies can also affect the extent to which health and medical coverage is available and accessible to patients. In this sense, such policies are entrenched in just about every aspect of healthcare in the United States.
Different Types of Healthcare Policies
There are several different types of healthcare policies that everybody working in the field should be aware of, each differing in terms of what they cover. Healthcare policies encompass various forms, including public health insurance like Medicare and Medicaid, private health insurance either through employers or individual plans, managed care plans for cost-effective comprehensive care, long-term care insurance for services not covered by regular health insurance, and much more.
Policies Around Patient Care
The purpose of patient care policies is to offer protocols and procedures for how healthcare professionals should respond to patients in certain medical situations. Typically, these policies are created and implemented from one medical facility to the next. A cardiovascular center, for example, would have much different patient care policies in place than a pediatrician’s office. The idea behind these policies is that they should be custom-tailored to the specific type of care being provided by the facility itself.
Policies for Employee Health
Employee health policies are also important because they provide guidance and protocols for workers in healthcare facilities to follow to protect their own health and safety. A medical office, for instance, may have strict employee health policies in place that require all workers to wear masks and gloves to reduce the risk of exposure to sick patients.
Drug Policies
For medical facilities where prescription medication or over-the-counter medication is administered, strict drug policies may also need to be in place to protect patients from administering medicine incorrectly or making other drug handling errors.
Privacy and Security Policies
All medical facilities also need to follow specific privacy and security policies to keep their information secure as well as the information provided by patients. This includes medical information and other potentially sensitive data. Following privacy and security policies in the healthcare field is critical to avoid breaches and facing fines and penalties related to the Healthcare Insurance Portability and Accountability Act (HIPAA).
How Healthcare Policies Affect Providers and Patients
Both policies and policy changes can affect both providers and patients in several ways.
Impact on Patient Care and Accessibility
In some cases, patient care and accessibility to care can be impacted by policies and policy changes. The Affordable Care Act, which was implemented in 2010, significantly increased the number of insured Americans and arguably made healthcare more accessible.
Influence on Healthcare Professionals and Institutions
When new policies are passed, healthcare professionals and medical facilities need to adhere to these policies to avoid being penalized or fined. This can result in the need for additional training and other changes to protocols that providers need to adjust to.
Current Healthcare Policy Issues and Challenges
Policy issues and challenges are known to change over time, but healthcare coverage/inclusivity and rising healthcare costs are a couple of examples of current issues facing the field.
Healthcare Coverage and Inclusivity
As healthcare costs have continued to increase, so has the cost of medical coverage. This, in turn, has made affording health insurance more difficult for many Americans and, in some cases, restricted access to healthcare for those who need it most.
Rising Healthcare Costs and Economic Implications
In addition to rising healthcare costs affecting patient care and access to health coverage, the economic implications of these rising costs have also affected healthcare workers and facilities alike. Some hospitals and other medical facilities have an increasingly harder time hiring and retaining medical staff, which has resulted in healthcare labor shortages across the board.
Recent Reforms in Healthcare Policies
Policy reforms are done with the goal of improving the healthcare system and to address ongoing challenges.
Major Policy Changes and Their Rationale
In recent years, a few healthcare policies have led to major reform within the field. Examples of these include the Affordable Care Act, the American Rescue Plan Act, and Medicare Access and CHIP Reauthorization Act (MACRA).
Affordable Care Act
Implemented in 2010, the Affordable Care Act established a nationwide marketplace for health insurance coverage while legally requiring all Americans to carry medical insurance.
American Rescue Plan Act
In the wake of the COVID-19 pandemic, this proposed act aims to eliminate or lower health insurance premiums for families and individuals enrolled in marketplace plans.
Medicare Access and CHIP Reauthorization Act (MACRA)
MACRA, which was signed into law in 2015, implemented policy changes that changed how physicians are paid by the federal government for Medicare services. The goal here is for physicians to prioritize quality of patient care over number of patients seen.
Evaluating the Impact of Recent Reforms
Healthcare policies affect a variety of stakeholders, ranging from patients and providers to insurers and even government agencies. These must all be taken into consideration when evaluating the overall impact of a policy. Likewise, evaluation of policy changes should be made with consideration of other important factors, such as access to care, quality of care, and cost.
Navigating the Complex Landscape of Healthcare Policies
Healthcare policies are inherently complicated, and staying up-to-date with compliance standards can be challenging for healthcare workers. Patients, too, can benefit from staying informed on the latest in healthcare policy changes as they relate to the care they receive.
The Importance of Understanding the Policy-Making Process
Providers and patients alike should take time to understand how policies are researched, proposed, passed, and implemented within the American healthcare system. In doing so, healthcare workers can understand how their own procedures may be affected and patients can better advocate for quality care. This also means understanding the various stakeholders involved in the policy-making process, such as the U.S. Congress, the Centers for Disease Control (CDC), and similar entities.
The Role of Healthcare Providers in Shaping Policies
Healthcare providers also have a responsibility to advocate for their patients and their own experiences as front-line workers. By understanding how the policy-making process works and how healthcare workers can get their own voices heard, it is possible for these professionals to have a say in how future policies affect their patients.
How to Prepare Future Prospects and Changes in Healthcare Policies
In addition to understanding the policymaking process, healthcare workers and patients alike can benefit from anticipating future policy shifts and addressing future policy changes proactively.
Predicted Policy Shifts and Their Potential Impact
Predicted policy shifts can impact patients and healthcare workers in a major way. However, when these policy shifts are anticipated with plenty of foresight and planning, this can influence the allocation of healthcare resources and the delivery of healthcare services.
The Role of Innovation and Technology in Shaping Future Policies
The healthcare field is far from static. New innovations and technologies are constantly emerging, and the healthcare field needs to be prepared to create policies around these new innovations as they emerge to protect patients and healthcare worker safety. This is especially true with new innovations in healthcare that we have seen in recent years, such as artificial intelligence (AI) and machine learning.
How Can You Prepare for Future Healthcare Policy Changes?
Being proactive and assessing readiness for future policy changes is a critical element to being prepared and having success as a worker in today’s dynamic healthcare system. By having a solid understanding of how policies are made, and the various stakeholders involved in the process, you can get involved as a healthcare professional and be proactive about changes that may affect your work.
Learn More About Healthcare Administration and How to Make a Difference
Johnson & Wales University offers undergraduate, graduate, and doctoral degree programs in more than 50 fields of study. Founded in 1914, Johnson & Wales has a current enrollment of around 8,000 undergraduate, graduate, and doctoral students. The university is accredited by the New England Commission of Higher Education. Financial aid is available for qualified students.
Interested in delving more into the details of healthcare policy and healthcare administration? Then it’s time to explore Johnson & Wales University’s online Bachelor of Science in Healthcare Administration. For more information about completing your degree online or on-campus, complete the Request Information form, call 855-JWU-1881, or email [email protected].