Policy Proposal and Interview

Policy Proposal and Interview

Luz Rodriguez

Southern New Hampshire University

Policy Proposal and Interview

All healthcare practitioners must have adequate knowledge regarding diverse state, national, or international healthcare policies that are applicable to the institutions that they work for. Such policies guide the way they operate when caring for patients and carrying out other relevant duties. There are legal, ethical, and professional ramifications for not adhering to such policies. In this regard, a brief review of a federal health policy is given.

Summary of the Policy

One vital health policy is the Hospital Readmissions Reduction Program (HRRP). The HRRP was established in 2012 under the Affordable Care Act (ACA). The HRRP is a Medicare value-based policy, which facilitates the reduction of payments to healthcare institutions that record excess readmissions. The HRRP links hospital care quality to payment with the objective of supporting the national objective of improving Americans’ healthcare. Therefore, the HRRP works to lower excessive hospital readmissions, enhance patient outcomes, facilitate patient safety, and reduce the costs of healthcare services (Gai & Pachamanova, 2019). According to McIlvennan, Eapen, & Allen, (2015), the HRRP allows the government to financially penalize institutions, which record “excessive risk-standardized 30-day readmission rates for pneumonia, myocardial infarction, and heart failure” (1796). Therefore, the HRRP is not only a quality measure but a way of curbing excessive costs of healthcare services.

Rationale for Choosing the Policy

The HRRP has both personal and professional relevance to all stakeholders involved in readmissions in hospitals. Lowering the number of readmissions is an effective means of reducing the spending of healthcare while simultaneously enhancing the quality of care. Patients with conditions such as heart attacks, heart failure, and pneumonia have a high likelihood of being readmitted excessively in hospitals (Joynt, Sarma, Epstein, Jha, & Weissman, 2014). Some hospitals do this to get more cash from people with such ailments while there are those that are simply incompetent. However, due to the hospital readmission penalties that are enforced by the HRRP, healthcare institutions must lower readmission of such patients by enhancing the quality of care that they give them.

However, it is vital to acknowledge that the reduction of readmissions is not simple because there are certain cases, which are unpreventable. The HRRP is marred with certain challenges, which make the policy seem unfair to some demographics and unsustainable in the long run. Examples of challenges are socio-economic demographic factors like poverty and readmissions that are unrelated to the original admission (Joynt, Sarma, Epstein, Jha, & Weissman, 2014). Therefore, there is a need for readjustments to the HRRP to ensure the policy accounts for issues that are beyond the control of the healthcare institutions.

Three Stakeholders that can be Interviewed

To provide insights into the current setup of the HRRP and suggest recommendations to mitigate the challenges of the policy, there are three stakeholders that can be interviewed. First, a patient with a chronic problem such as heart attacks can be interviewed. This stakeholder can offer his/her views on the need for quality healthcare to lower his/her chances of going back to the hospital for the same issue. Second, an interview can be done to a doctor in a large public hospital. This stakeholder can discuss issues to do with dealing with the readmission of patients with ailments that are unrelated to the original admission. I have chosen to interview the patient because I always like to learn things from a consumer’s perspective. Finally, an official in the health ministry can be interviewed. This stakeholder can discuss the problem of lowering costs while ensuring that people from disadvantaged backgrounds are not hurt by the policy.

References

Gai, Y., & Pachamanova, D. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable populations. BMC Health Services Research19(1), 837.

Joynt, K. E., Sarma, N., Epstein, A. M., Jha, A. K., & Weissman, J. S. (2014). Challenges in reducing readmissions: lessons from leadership and frontline personnel at eight minority-serving hospitals. The Joint Commission Journal on Quality and Patient Safety40(10), 435-AP7.

McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation131(20), 1796-1803.

Luz Rodriguez

Southern New Hampshire University

Policy Proposal and Interview

All healthcare practitioners must have adequate knowledge regarding diverse state, national, or international healthcare policies that are applicable to the institutions that they work for. Such policies guide the way they operate when caring for patients and carrying out other relevant duties. There are legal, ethical, and professional ramifications for not adhering to such policies. In this regard, a brief review of a federal health policy is given.

Summary of the Policy

One vital health policy is the Hospital Readmissions Reduction Program (HRRP). The HRRP was established in 2012 under the Affordable Care Act (ACA). The HRRP is a Medicare value-based policy, which facilitates the reduction of payments to healthcare institutions that record excess readmissions. The HRRP links hospital care quality to payment with the objective of supporting the national objective of improving Americans’ healthcare. Therefore, the HRRP works to lower excessive hospital readmissions, enhance patient outcomes, facilitate patient safety, and reduce the costs of healthcare services (Gai & Pachamanova, 2019). According to McIlvennan, Eapen, & Allen, (2015), the HRRP allows the government to financially penalize institutions, which record “excessive risk-standardized 30-day readmission rates for pneumonia, myocardial infarction, and heart failure” (1796). Therefore, the HRRP is not only a quality measure but a way of curbing excessive costs of healthcare services.

Rationale for Choosing the Policy

The HRRP has both personal and professional relevance to all stakeholders involved in readmissions in hospitals. Lowering the number of readmissions is an effective means of reducing the spending of healthcare while simultaneously enhancing the quality of care. Patients with conditions such as heart attacks, heart failure, and pneumonia have a high likelihood of being readmitted excessively in hospitals (Joynt, Sarma, Epstein, Jha, & Weissman, 2014). Some hospitals do this to get more cash from people with such ailments while there are those that are simply incompetent. However, due to the hospital readmission penalties that are enforced by the HRRP, healthcare institutions must lower readmission of such patients by enhancing the quality of care that they give them.

However, it is vital to acknowledge that the reduction of readmissions is not simple because there are certain cases, which are unpreventable. The HRRP is marred with certain challenges, which make the policy seem unfair to some demographics and unsustainable in the long run. Examples of challenges are socio-economic demographic factors like poverty and readmissions that are unrelated to the original admission (Joynt, Sarma, Epstein, Jha, & Weissman, 2014). Therefore, there is a need for readjustments to the HRRP to ensure the policy accounts for issues that are beyond the control of the healthcare institutions.

Three Stakeholders that can be Interviewed

To provide insights into the current setup of the HRRP and suggest recommendations to mitigate the challenges of the policy, there are three stakeholders that can be interviewed. First, a patient with a chronic problem such as heart attacks can be interviewed. This stakeholder can offer his/her views on the need for quality healthcare to lower his/her chances of going back to the hospital for the same issue. Second, an interview can be done to a doctor in a large public hospital. This stakeholder can discuss issues to do with dealing with the readmission of patients with ailments that are unrelated to the original admission. I have chosen to interview the patient because I always like to learn things from a consumer’s perspective. Finally, an official in the health ministry can be interviewed. This stakeholder can discuss the problem of lowering costs while ensuring that people from disadvantaged backgrounds are not hurt by the policy.

References

Gai, Y., & Pachamanova, D. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable populations. BMC Health Services Research19(1), 837.

Joynt, K. E., Sarma, N., Epstein, A. M., Jha, A. K., & Weissman, J. S. (2014). Challenges in reducing readmissions: lessons from leadership and frontline personnel at eight minority-serving hospitals. The Joint Commission Journal on Quality and Patient Safety40(10), 435-AP7.

McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation131(20), 1796-1803.

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