Ethical and Policy Factors in Care Coordination

Ethical and Policy Factors in Care Coordination

Hello everyone. I want to take you through the ethical and policy factors related to care coordination. We must learn these factors to uphold ethical standards and navigate various policy issues affecting patient care.

Presentation Outline

The presentation outline is as follows. We will first look at how government policies related to the health and safety of a community affect the coordination of care. We will then identify the national, state, and local policy provisions that raise ethical dilemmas for care coordination. An assessment of the impact of the code of ethics for nurses on coordination and continuum of care will then be done. We will end our presentation by outlining the critical ethical and policy issues affecting the coordination and continuum of care for nursing homes.

Impact of Governmental Policies on Care Coordination

Government policies on healthcare affect the costs citizens pay for care, their access to care, and the quality of care they receive. The Patient Protection and the Affordable Care Act demonstrate how healthcare policies impact individuals’ health and access to healthcare. The ACA was introduced to increase healthcare access, lower healthcare costs, incentivize care coordination, and improve the quality of care (Emmer, 2016). ACA has provisions like the Medicare Community-based Care Transitions Program that assess the models for enhancing care transitions from the hospital to other healthcare sites, lessening readmissions for high-risk Medicare beneficiaries, and saving Medicare funds. Accountable Care Organizations that coordinate health care providers, hospitals, and physicians to generate holistic care for Medicare beneficiaries is also an important government policy.

The government has introduced new bonus payments for primary care practitioners (up to $20 for every patient), funded under the Affordable Care Act to enhance coordination of care under the Comprehensive Primary Care Initiative. Research shows significant improvements in primary care delivery, including enhanced access, improved care management for high-risk patients, and enhanced coordination of care transitions (Peikes et al., 2018). The growth of patients from nursing homes and hospitals to their homes and back to a hospital setting costs Medicare about $15 million a year (National Library of Medicine, 2017). By providing transitional care and enhancing care coordination, re-hospitalizations are lessened, and improved patient outcomes. Furthermore, the initiative helps manage care for high-risk patients, deliver preventive care, engage caregivers and patients, and coordinate care across the medical neighborhood (Center for Medicare $ Medicaid Services, 2017).

Policy Provisions Raising Ethical Dilemmas For Care Coordination

The issue of health care reform is linked to specific critical ethical issues of justice as the legislature, individuals, and communities struggle to provide quality health care for the many without necessarily sacrificing the fundamental rights of the few. The ACA is one of the policy provisions that raises some ethical dilemmas. For one, the ACA requires improved quality of care offered to patients but at a lower cost. Provisions in the act are designed to control costs, expand insurance coverage, and target prevention (Sorrell, 2017). However, the ACA provisions increase the general budget, which might imply more debt for the country, and this effect might trickle down to reduced funding that might affect care coordination and health care in general.

There are still concerns that even though ethnic/racial and income disparity gaps have been narrowed, such differences still exist (Buchmueller et al., 2016). For instance, in 2017, 25% of Hispanics, 14% of Blacks, and 8.5% of Whites are said to have lacked health insurance (Gavin, 2020). Various individuals remain uninsured and underinsured, which might pose a challenge while coordinating care for individuals in nursing homes. Furthermore, for companies with less than 50 workers, insurance coverage is not mandated by the ACA, which might mean an increased cost of care for such employees. For employers, the central ethical dilemma is the extent to which they should avail health coverage to their employees at affordable rates, especially if the state and federal government plans offer little or no range for the residents and the costs of the employer-provided range skyrocket