Health Care Policy Development Process
Health Care Access and Quality, as defined in the Healthy People 2030 program, aims to increase the coverage of the patient population with quality and comprehensive healthcare services. Nevertheless, one of the related objectives under this goal, “Increase the proportion of persons with a usual primary care provider,” has the exact cause of concern. Achieving this goal is essential as it is responsible for preventing primary conditions, early detection of diseases, and ensuring that the conditions are managed effectively. As the chairperson of a task force responsible for improving the health of the Houston populace as the focus of this whitepaper, I intend to identify different stakeholders and suggest strategies to enable us to achieve the established goal.
Selected Objective and Current Status
Objective: Increase the proportion of persons with a usual primary care provider.
Score: “Little or no detectable change”
Research and Contributing Factors
The CDC (Centers for Disease Control and Prevention) estimated that in 2019, about 27.8% of the adult population in the U. S, between 18 and 64 years old, will have no usual primary care provider (CDC, 2019). Several factors contribute to this issue, including:
Lack of Health Insurance or Inadequate Coverage
Affordability emerging as a significant problem for a number of individuals—in particular, the ones who are living in poverty or who receive no insurance from their employers—is a common issue with respect to healthcare services and locating providers that are willing to accept the insurance of these individuals.
Provider Shortage and Maldistribution
The undersupply of primary care physicians, particularly in rural and less advantaged urban communities, makes it an uphill task for people to obtain assistance.
Lack of Awareness
Certain individuals do not know the value of utilizing the services or may be unaware of the options and techniques available to them.
Transportation Barriers
People residing in zones with a deficit of public transportation or mobility challenges may have problems taking a means to the health complexes.
Stakeholder Analysis
Engaging stakeholders who shape healthcare policy and practice is essential to achieving this goal. The following stakeholders have been identified:
- Patients and Community Members:
- Patients and community members benefit most from better access to primary care professionals.
- To build successful tactics, it is essential to understand their viewpoints, needs, and obstacles.
- Primary Care Providers:
- Physicians, nurse practitioners, and other healthcare professionals in primary care settings are essential stakeholders.
- They provide vital insights into workforce difficulties, reimbursement mechanisms, and patient engagement initiatives.
- Healthcare Facilities and Organizations:
- Community health centres, hospitals, and healthcare systems are crucial for primary care services.
- Their ability, resources, and outreach initiatives significantly affect care access.
- Insurance Companies and Payors:
- Private and public insurance companies impact primary care access via coverage policies and provider networks.
- The reimbursement mechanisms and incentives might affect provider availability and cost.
- Local and State Government:
- Health departments, Medicaid agencies, and policymakers influence healthcare rules and financing.
- The policies and efforts may alleviate provider shortages, boost insurance coverage, and enhance healthcare infrastructure.
- Federal Government and Agencies:
- The Centers for Medicare & Medicaid Services (CMS) and the Health Funding and Services Administration (HRSA) are important federal organizations that determine national healthcare policy and allocate funding.
- Their efforts and financing programs may enhance employment development, community engagement, and healthcare access.
- Advocacy Groups and Nonprofit Organizations:
- The American Academy of Family Physicians (AAFP), the National Association of Community Health Centers (NACHC), and local patient advocacy organizations may promote policy changes.
Proposed Tactics
The following strategies are put up to tackle the goal of improving the percentage of Houston residents who have a regular primary care physician:
Expand Primary Care Workforce and Incentives
Join local medical schools, nursing programs, and healthcare institutions to expand primary care residency and training options and/or promote state and federal measures to recruit and retain primary care practitioners in disadvantaged regions, including debt forgiveness and increased reimbursement rates.
Implement Community-Based Outreach and Education Programs
Partnerships with community organizations, faith-based groups, and local leaders should be crucial in ensuring that information about the benefits of having a regular primary care provider and sources of help are appropriately disseminated (Haldane et al., 2019) and/or produce educational materials that are linguistically and culturally acceptable. In addition, targeted community outreach programs should be ensured to reach neighbourhoods with a low rate of primary healthcare utilization.
Enhance Access to Health Insurance and Affordable Care
Advocate for policies that expand access to affordable health insurance coverage, such as Medicaid expansion or subsidized insurance plans and/or work with local healthcare providers and community health centres to offer sliding-scale fees or discounted services for individuals without insurance.
Improve Transportation and Telehealth Options
Collaborate with local transportation authorities and healthcare facilities to establish shuttle services or subsidized transportation options for individuals seeking primary care services and/or promote and support the adoption of telehealth services, allowing individuals to access primary care providers remotely and reducing transportation barriers.
Develop a Comprehensive Primary Care Access Policy
Engage with local and state policymakers to develop a comprehensive policy framework that addresses primary care workforce development, insurance coverage, community outreach, and infrastructure improvements and/or advocate for allocating resources and funding to support the implementation of this policy.
Stakeholder Engagement
Engaging stakeholders throughout the policy development and implementation process is essential to successfully implement the proposed tactics. The task force can facilitate stakeholder engagement through the following strategies. First, they can establish a stakeholder advisory council comprising representatives from various stakeholder groups, including patients, providers, healthcare facilities, payors, government agencies, and advocacy organizations (Masefield et al., 2021; Petkovic et al., 2020). Second, conducting regular community forums and focus groups would help gather input, identify barriers, and understand different populations’ unique needs and perspectives. Third, the task force can collaborate with healthcare professional associations, such as the Harris County Medical Society and the Texas Nurses Association, to involve providers in workforce development initiatives and policy discussions.
Fourth, to maximize resources and financing, the task force can collaborate with local and state government entities, such as the Houston Health Department and the Texas Health and Human Services Commission. Fifth, collaborating with advocacy groups and nonprofits will help promote awareness, organize support, and empower underrepresented populations (Masefield et al., 2021; Petkovic et al., 2020). Finally, collaborating with insurance companies and payors will enhance primary care access via new payment methods, provider network expansions, and coverage policies.
The task force can guarantee that suggested policies meet Houston’s particular demands and achieve broad support for sustainable, long-term solutions by actively involving stakeholders throughout policy formulation and implementation.
Conclusion
Providing increased access to the broader spectrum of medical care provision covers a deep and complicated problem that needs a joint and multi-layered approach from the community. The task force can achieve this by involving stakeholders such as patients and providers, healthcare facilities, payors, government bodies, and advocacy groups to develop and implement an array of solutions that increase the patient base of Houston. Via workforce improvement measures, community involvement, and public enlightenment, deepening insurance coverage, advancing transportation choices, and adopting comprehensive access to primary care policy, the team will be able to make breakthroughs towards the attainment of the Health Care Access and Quality objective laid out in the Healthy People 2030 initiative.
References
CDC. (2019). FastStats – Health insurance coverage. Centres for Disease Control and Prevention. https://www.cdc.gov/nchs/fastats/health-insurance.htm
Haldane, V., Chuah, F. L. H., Srivastava, A., Singh, S. R., Koh, G. C. H., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLoS One, 14(5). https://doi.org/10.1371/journal.pone.0216112
Masefield, S. C., Msosa, A., Chinguwo, F. K., & Grugel, J. (2021). Stakeholder engagement in the health policy process in a low income country: A qualitative study of stakeholder perceptions of the challenges to effective inclusion in Malawi. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-07016-9
Petkovic, J., Riddle, A., Akl, E. A., Khabsa, J., Lytvyn, L., Atwere, P., Campbell, P., Chalkidou, K., Chang, S. M., Crowe, S., Dans, L., Jardali, F. E., Ghersi, D., Graham, I. D., Grant, S., Smith, R. G., Guise, J.-M., Hazlewood, G., Jull, J., & Katikireddi, S. V. (2020). Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation. Systematic Reviews, 9(21), 1–11. https://doi.org/10.1186/s13643-020-1272-5
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Question 
You are chairperson of a task force focused on improving the health of your community. In this role, you have been asked to identify a critical need in your community and develop a framework for addressing this need. In this framework, you will identify the various stakeholders involved in the development of healthcare policy that will address this need and influence outcomes. In addition, address the roles of the stakeholders (local, state, or federal government) as appropriate to address this health care need.
Health Care Policy Development Process
Preparation
Review the Health Care Access and Quality page of the Healthy People 2030 website. The goal of Health Care Access and Quality is to increase access to comprehensive, high-quality healthcare services. There are several related objectives, each of which is scored based on the program’s success or failure.
Select 1 of the related objectives that are scored as either “little or no detectable change” or “getting worse.”
Research your selected objective and identify the factors that have contributed to or are contributing to failure.
Analyze the stakeholders for this selected objective, and develop a framework for engaging these stakeholders to facilitate success or improvement in the objective.
There are several groups of stakeholders that influence the healthcare policy development process and ultimately help shape our healthcare policies. These groups of stakeholders are often referred to as the 4 Ps:
Patients are the largest consumers of health care. The needs and wants of the public (disparities) also drive the decisions made by healthcare decision-makers.
Providers: physicians, advanced practice nurses, pharmacists, nurses
Payors: insurance companies
Policymakers: government agencies and interest groups such as AARP, the American Medical Association, and KFF