Ethical and Policy Factors in Care Coordination

Ethical and Policy Factors in Care Coordination

Hello and welcome to today’s presentation on the crucial intersection of ethics and policy in care coordination, particularly within the realm of the American Cancer Society (ACS). As we embark on this journey together, we will explore how governmental policies, nursing ethics, and social determinants of health profoundly impact the coordination and continuum of care for individuals affected by cancer. Through insightful discussions and evidence-based analysis, we will uncover the ethical dilemmas and policy challenges faced by the ACS, and examine the implications of these factors on the provision of equitable and comprehensive cancer care. Thank you for joining us on this important exploration.

Presentation Outline

The outline for the presentation begins with an introduction to the objectives, focusing on the importance of governmental policies, ethics, and social determinants of health in care coordination, particularly within the American Cancer Society (ACS). I will then address the impact of governmental policies on care coordination, highlighting specific examples such as the Health Insurance Portability and Accountability Act (HIPAA) and identifying ethical dilemmas raised by national, state, and local policy provisions. The role of the nursing code of ethics in care coordination and its influence on addressing health disparities and access to services are explored. Additionally, the presentation considers the social determinants of health identified in Healthy People 2020 and their implications for ACS care coordination efforts. Finally, the presentation communicates key ethical and policy issues affecting ACS care coordination, supported by relevant evidence. It concludes with a call to action for advocacy and equitable access to cancer care.

Policy Impact on the American Cancer Society

Health Insurance Portability and Accountability Act (HIPAA), a governmental policy, profoundly influences the coordination of cancer care within the American Cancer Society (ACS). By prioritizing patient privacy and confidentiality, HIPAA restricts the sharing of medical information among healthcare providers, presenting communication challenges across care teams. Compliance mandates secure handling of medical records and necessitates obtaining patient consent for information disclosure. This regulatory framework significantly affects data exchange protocols essential for effective care coordination. Ultimately, navigating HIPAA’s provisions involves balancing the imperative of safeguarding privacy rights with the imperative of facilitating seamless coordination among various healthcare entities involved in cancer care within the American Cancer Society’s framework (Viale, 2020).

Policy Impact on the American Cancer Society

Governmental policies such as Medicare and Medicaid regulations significantly impact care coordination within the framework of the American Cancer Society (ACS). Medicare’s coverage for cancer treatments dictates the scope of services available to patients, while Medicaid’s influence on access to care affects the availability of resources for underserved populations. Reimbursement policies associated with these programs directly influence service delivery and provider participation in care coordination efforts. Patient access to specialized cancer care is often contingent upon compliance with billing and coding requirements set forth by these programs. Moreover, these policies shape the ACS’s advocacy efforts, guiding initiatives aimed at ensuring equitable access to cancer care for all individuals, regardless of socioeconomic status or insurance coverage (Trein, et al., 2021). Ultimately, navigating these regulations is essential for facilitating effective and inclusive care coordination within the ACS’s community-focused approach to cancer care.

The Affordable Care Act (ACA) provisions profoundly influence care coordination within the ACS. These policies enhance accessibility to preventive care services, expanding coverage for cancer screenings crucial for early detection. By ensuring the affordability of health insurance, the ACA facilitates access to vital interventions and treatments for individuals diagnosed with cancer. Moreover, the emphasis on early detection and intervention supported by ACA provisions aligns with the ACS’s mission, promoting better health outcomes and safety for the community. Additionally, the ACA reinforces the ACS’s advocacy efforts for equitable access to cancer care, fostering partnerships with healthcare providers and organizations to deliver comprehensive support and services to individuals affected by cancer (Trein, et al., 2021).

Ethical Dilemmas in National Policy Provisions

National policy provisions can present significant ethical dilemmas for the American Cancer Society (ACS) in the coordination of care. These include balancing patient privacy rights with the need for information sharing, ensuring equitable access to care for all individuals affected by cancer, and navigating complex regulatory landscapes that may impede effective coordination efforts. Additionally, dilemmas arise in allocating resources fairly and transparently, addressing conflicting interests among stakeholders, and upholding principles of autonomy and beneficence in decision-making processes (Viale, 2020) . The consequences of these dilemmas can manifest in breaches of patient confidentiality, disparities in access to care, and challenges in obtaining informed consent for research or treatment options.

Ethical Dilemmas in State Policy Provisions

State policy provisions can present ethical dilemmas for the American Cancer Society (ACS) in its mission to coordinate care effectively. These provisions often influence access to care for underserved populations, raise questions about the prioritization of funding allocations, and create conflicts between state and federal regulations. For example, balancing patient confidentiality with mandatory reporting requirements poses a significant ethical challenge.

Additionally, resource allocation within public health systems can lead to difficult decisions about where to allocate limited resources. Moreover, conflicts among stakeholders may arise regarding the implementation and interpretation of state policies. The implications of these dilemmas include disparities in access to cancer care, tensions among stakeholders, and challenges in aligning state policies with federal mandates (Trein, et al., 2021). Addressing these ethical considerations requires careful deliberation, transparency, and a commitment to promoting equitable access to care for all individuals affected by cancer within the ACS framework.

Ethical Dilemmas in Local Policy Provisions

Local policy provisions can pose ethical dilemmas for the American Cancer Society (ACS) in its efforts to coordinate care effectively. These provisions may include limited funding for cancer services, leading to disparities in access to care among different communities. Regulatory hurdles can impede coordination efforts, while conflicts of interest may arise in allocating resources. Additionally, balancing patient privacy with the need for data sharing presents ethical challenges (Trein, et al., 2021). Community engagement and transparency can also be challenging in navigating local policies.

The implications of these dilemmas include unequal access to cancer services, gaps in care for underserved populations, and tensions between maintaining patient privacy and sharing necessary data for coordination. Consequences may include increased burden on already vulnerable communities, difficulties in coordinating care effectively, and challenges in maintaining trust within the community (Trein, et al., 2021). Addressing these ethical considerations requires careful deliberation, advocacy for equitable policies, and transparent communication with all stakeholders involved in cancer care coordination within the ACS framework.

Impact of Nursing Code of Ethics

The Nursing Code of Ethics significantly impacts the coordination and continuum of care within the American Cancer Society. By emphasizing patient-centered care, integrity, and advocacy for equitable access to services, nurses uphold standards that contribute to improved health outcomes and reduced health disparities. Nurses play a crucial role in ensuring patient safety, well-being, and trust among stakeholders involved in cancer care. Their adherence to ethical principles guides decision-making processes, ensuring that care delivery aligns with the ACS’s mission to support individuals affected by cancer through every stage of the care continuum. Moreover, nurses’ commitment to ethical conduct fosters collaboration among healthcare providers, patients, and their families, promoting a holistic approach to cancer care (Rushton et al., 2021). Overall, the Nursing Code of Ethics serves as a cornerstone for nurses in their roles within the ACS, reinforcing the organization’s commitment to ethical and patient-centered care coordination.

Social Determinants of Health in Healthy People 2020

Within the framework of the American Cancer Society, the Social Determinants of Health (SDH) identified in Healthy People 2020 offer a holistic lens through which to assess the multifaceted factors influencing health outcomes. These determinants include neighborhood and built environment, social and community context, health and healthcare inequities, economic stability, and access to and quality of education and healthcare. By considering these SDH, the ACS can develop targeted interventions to address health disparities and promote health equity among diverse populations affected by cancer. Integrating SDH into care coordination efforts allows the ACS to tailor programs and services to meet the specific needs of communities, improving cancer prevention, detection, treatment, and survivorship outcomes (Ghaffari et al., 2020). Recognizing and addressing the social factors impacting health outcomes is essential for the ACS to fulfill its mission of reducing the burden of cancer and enhancing the well-being of individuals and communities nationwide.

Key Ethical Issues in Care Coordination

In the care coordination for the American Cancer Society, several key ethical issues demand attention. Maintaining patient confidentiality while facilitating essential information sharing among healthcare providers is a delicate balance crucial for effective care coordination. Ensuring equitable access to cancer care for all individuals, regardless of socioeconomic status or other factors, upholds the ethical principle of fairness and justice. Respecting patient autonomy involves empowering individuals to make informed decisions about their care while considering their preferences and values. Ethical care coordination also entails making treatment decisions based on the principle of beneficence, prioritizing the well-being and best interests of patients.

Avoiding conflicts of interest and upholding transparency in decision-making processes further uphold the integrity of care coordination efforts (Rushton et al., 2021). Ultimately, navigating these ethical complexities is essential for the ACS to provide compassionate, patient-centered care and promote positive outcomes for individuals affected by cancer throughout their care journey.

Key Policy Issues in Care Coordination

In the coordination of the American Cancer Society, several key policy issues warrant attention. Health insurance coverage limitations, including gaps in coverage for certain cancer treatments or services, pose significant barriers to accessing comprehensive care. Medicare and Medicaid reimbursement regulations influence the availability and affordability of cancer treatments, impacting patients’ ability to receive timely and adequate care. Provisions within the Affordable Care Act (ACA) also play a critical role in shaping the continuum of care for individuals affected by cancer, particularly regarding access to preventive services and insurance coverage. Additionally, compliance with the Health Insurance Portability and Accountability Act (HIPAA) and navigating state-specific healthcare regulations are essential considerations for ensuring patient privacy and regulatory adherence. Access to cancer treatment facilities further affects the coordination of care, particularly for individuals residing in underserved or rural areas (Cook & Trundle, 2020). Addressing these policy issues is vital for the ACS to fulfill its mission of providing comprehensive and equitable care to individuals affected by cancer throughout their care journey.

References

Cook, J., & Trundle, C. (2020). Unsettled care: Temporality, subjectivity, and the uneasy ethics of care. Anthropology and Humanism, 45(2), 178-183. https://doi.org/10.1111/anhu.12308

Ghaffari, A., Wells, R., Creel, L., & Siañez, M. (2020). A relational perspective on care coordination. Health care management review, 45(2), 96-105. 10.1097/HMR.0000000000000208

Rushton, C. H., Swoboda, S. M., Reller, N., Skarupski, K. A., Prizzi, M., Young, P. D., & Hanson, G. C. (2021). Mindful ethical practice and resilience academy: Equipping nurses to address ethical challenges. American Journal of Critical Care, 30(1), e1-e11. https://doi.org/10.4037/ajcc2021359

Trein, P., Biesbroek, R., Bolognesi, T., Cejudo, G. M., Duffy, R., Hustedt, T., & Meyer, I. (2021). Policy coordination and integration: A research agenda. Public Administration Review, 81(5), 973-977.

Viale, P. H. (2020). The American Cancer Society’s Facts & figures: 2020 edition. Journal of the Advanced Practitioner in Oncology, 11(2), 135. https://doi.org/10.6004%

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Ethical and Policy Factors in Care Coordination

Instructions
Resources
Activity
Attempt 1
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Attempt 2
Attempt 3

Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation, with audio, intended for that audience. Create a detailed narrative script or speaker notes for your presentation, 4-5 pages in length.

Ethical and Policy Factors in Care Coordination

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Introduction
This assessment provides an opportunity for you to develop a presentation for a local community organization, which provides an overview of ethical standards and relevant policy issues that affect the coordination of care. Completing this assessment will strengthen your understanding of ethical issues and policies related to the coordination and continuum of care, and will empower you to be a stronger advocate and nursing professional.

Preparation
It would be an excellent choice to complete the Vila Health: Ethical Decision-Making activity prior to developing the presentation. The activity provides a helpful update on the ethical principles that will help with the success of this assessment.

Scenario
Your nurse manager at the community care center is well-connected and frequently speaks to a variety of community organizations and groups. She has noticed the good work you are doing in your new care coordination role and respects your speaking and presentation skills. Consequently, she thought that an opportunity to speak publicly about contemporary issues in care coordination would be beneficial for your career and has suggested reaching out to a community organization or support group to gauge their interest in hearing from you, as a care center representative, on a topic of interest to both you and your prospective audience. You have agreed that this is a good idea and have decided to research a community organization or support group that might be interested in learning about ethical and policy issues related to the coordination of care.