The Role of the RN/APRN in Policy Evaluation

Evaluation Topic: The Affordable Care Act (ACA)

The Affordable Care Act (ACA) aimed to expand healthcare access, reduce costs, and improve care quality. Evaluating the ACA involves analyzing its success in achieving these objectives, focusing on criteria such as the uninsured rate, healthcare spending, and patient outcomes. Medicaid expansion and the creation of health insurance exchanges were key provisions intended to increase coverage for low-income populations (Ercia, 2021). The evaluation process examines whether these provisions have improved access to care and reduced healthcare inequalities.

Social Determinants Impacting this Issue

Social determinants such as income, education, geographic location, and race significantly influence the effectiveness of the ACA. While Medicaid expansion benefited many low-income individuals, in states that did not expand Medicaid, gaps in coverage persist (Artiga & Hinton, 2018). Rural populations face challenges due to healthcare provider shortages, limiting access to services even for those with insurance. Additionally, educational disparities affect individuals’ ability to navigate the complex health insurance marketplace, limiting their ability to access ACA benefits (Lee et al., 2021). Addressing these social determinants is critical to fully realizing the ACA’s potential.

Consistently, nurses are well-positioned to engage in policy evaluation due to their direct experience with patient care. In their capacities as patient advocates, RNs and APRNs can determine the effectiveness of such policies as ACA on the patterns of patient outcomes, access to care, and systems’ productivity (Flaubert, 2021). Through policy analysis, nurses guarantee that healthcare reforms are a match for the needs of persons on care, want a fair deal on social determinants of health for vulnerable groups, and note gaps. It is crucial to utilize their first line of experiences to dictate just better and more inclusive healthcare policies.

References

Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: Perspectives from FQHC administrators in Arizona, California, and Texas. BioMed Central (BMC) Health Services Research, 21(1), 1–9. https://doi.org/10.1186/s12913-021-06961-9

Flaubert, J. (2021). The Role of Nurses in Improving Health Care Access and Quality. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Lee, H., Hodgkin, D., Johnson, M. P., & Porell, F. W. (2021). Medicaid Expansion and Racial and Ethnic Disparities in Access to Health Care: Applying the National Academy of Medicine Definition of Health Care Disparities. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 58(78), 004695802199129. https://doi.org/10.1177/0046958021991293

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A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

• In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
• Review the Resources and reflect on the role of professional nurses in policy evaluation.
• Select an existing healthcare program or policy evaluation or choose one of interest to you.
• Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
  

  The Role of the RN/APRN in Policy Evaluation

Prompt:

• Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.

Textbook:

• Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning
  • Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)