Nursing Leadership Health Policy Paper

Nursing Leadership Health Policy Paper

Details:
The IOM Future of Nursing report calls for an increase in leadership from nurses at all levels. One way nurses demonstrate their role as a leader, is through public policy change. A leader does not always carry an official title or position, but demonstrates leadership through the work and the stance the leader takes to make a change for the good of others. Nurses have been noted by the Gallop poll year after year as the most trusted professionals.

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This assignment requires thought about a public policy that is needed or needs to be changed that relates to nursing, health care, or the public. Policy changes can occur by working with members of your legislature, and state or national nurses associations, to introduce a new bill and/or change to a current law in your state or federal government Nursing Leadership Health Policy Paper.

Examples of public policy includes any component of the current legislation governing health care, Medicare Part D, Medicaid, nursing regulation, medication technicians, etc.

In 750-1,000 words, propose a health policy change (that is currently a bill, a law, or may not exist at all) at the state or federal level that you believe needs to change and why.

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan Nursing Leadership Health Policy Paper.
Include a specific section for the exact wording for the bill or change in wording of the law.
Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.
Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations). Are these individuals also influential in making changes occur? Did you vote for the individual in office that you want to help you make this change? Nursing Leadership Health Policy Paper.
Resources:

Review different pieces of legislation for ideas on wording.
Visit your state’s legislative governmental affairs website site to understand the process your policy change could take if you wanted to introduce to into legislation.

 

Legislative Change

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan. Include a specific section for the exact wording for the bill or change in wording of the law.

The Medicare Prescription Drug, Improvement, and Modernization Act that was passed in 2003 presents a policy for managing Medicare. The legislation added a new section (Part D) to the Medicare Program that allowed private entities to be reimbursed by Medicare for prescription drugs they provide to Medicare beneficiaries. Although the new legislation offers greater benefits for the beneficiaries, it presents an opportunity for fraud. This is particularly true when claims are made for improper rebates, red-lining, enrollment fraud, overcharging, and duplicate billing (False Claims Act, 2018) Nursing Leadership Health Policy Paper. The implication is that the legislation has a glaring loophole that can easily be exploited through fraud.

The loophole in the legislation should be addressed through institutional changes that include greater oversight, inclusion, and control from a body comprised of representatives from all stakeholders, with stricter checks and double verification systems. In fact, there is a need to revise the legislation by calling for mandatory institutional changes. This conceptualized change is best understood by exploring the causes of fraud in health care. Harris (2015) mentions that greater control, inclusion and oversight should minimize the opportunities for fraud in medical care. This assessment is based on the fact that these measures would improve healthcare efficiency and competitiveness while encouraging good governance, values and norms (Harris, 2015).

Emanuel (2014) mentions that although fraud is considered a vice by most stakeholders, there are those who embrace the practice and would be resistant to any change that eliminates fraud. This is especially true for the health care industry where both personnel and facilities readily participate in fraudulent activities in quid pro quo trade that sees benefits flowing both ways. For instance, some medical facilities earn substantial profits from fraudulent Medicare claims that they then share with the personnel who facilitated the earnings. This makes it clear that there is a need to consider the distinguishing features of both personnel and facilities (along with other stakeholders in the medical industry). The consideration helps in defining how the stakeholders would apply their strategic plans. For example, it would show how a facility that benefits from fraud would react to legislative efforts to curb fraud (Emanuel, 2014).

Political economists confirm that fraud is resultant of resource scarcity and limited competition. In fact, a succinct assessment shows that weak governance enables fraud. Case in point, some facilities are pressured by their environment to enable fraud as a salient industry practice. In such cases, the facilities that do not enable fraud may finds that they position becomes insecure within the industry with some of them being targeted (Teitelbaum & Wilensky, 2013) Nursing Leadership Health Policy Paper. In this respect, the proposed change to the legislation would entail including a clause that calls for mandatory institutional changes (greater oversight, inclusion, and control) with stricter checks and double verification systems to reduce the opportunities for fraud. In essence, the proposed legislative change argues that adequate oversight and regulation through the current legislation’s loopholes will allow for greater accountability, oversight and regulation to reduce the opportunities for fraud Nursing Leadership Health Policy Paper.

Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.

The first step in implementing the policy development is to explore the existing problem. In this case, the shortcomings in the current legislation must be identified and explored with the opportunities for fraud well highlighted. Next, a range of solutions are developed through exploring literature and holding discussion. This is followed by identifying the most viable solution with the best chance of succeeding. The solution is then framed as a legislation and further explored for its value in solving the existing problem. The key stakeholders would then be identified, focusing on the persons with the potential to influence legislative activities. Lobbying for the legislative change would ensure whereby these stakeholders are approached to improve their buy in into the proposed legislative change Nursing Leadership Health Policy Paper. Once their stakeholders support is garnered, the proposed legislative change would then be presented to the appropriate legislative assemblies (such as Congress) to discuss the change and pass it based on its merits. The final step would be to implement the legislative change to include monitoring in action.

Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations).

The champion for the legislative change would be legislators. That is because their primary responsibility is to ensure that public resources are allocated to areas that are most in need. By eliminating opportunities for fraudulent Medicare claims, legislators are able to save the funds that would then be allocated towards other healthcare needs. Nursing Leadership Health Policy Paper.

Are these individuals also influential in making changes occur?

It is notable that legislators are influential in making the change occur since their official responsibility is to debate legislation, discarding those without public merit and passing those with public merit.

Did you vote for the individual in office that you want to help you make this change?

Although I did not vote for my legislator, this will not influence whether or not I would receive help. That is because the legislator is a publicly elected official who is accountable to the whole electorate and would evaluate the proposed change based on its merits and demerits Nursing Leadership Health Policy Paper.

References

Emanuel, E. (2014). Reinventing American Health Care: How the Affordable Care Act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system. New York, NY: Public Affairs Publications.

False Claims Act (2018). Health Care Fraud and False Claims. Retrieved from https://www.falseclaimsact.com/common-types-of-fraud/health-care-fraud

Harris, M. (2015). Handbook of Home Health Care Administration (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Teitelbaum, J. & Wilensky, S. (2013). Essentials of Health Policy and Law (2nd ed.). Sunbury, MA: Jones & Bartlett Learning Nursing Leadership Health Policy Paper.

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