NURS 4050 Assessment 3: Care Coordination Presentation to Colleagues Assessment 3: Care Coordination Presentation to Colleagues

Government policies play a crucial role in enabling the coordination of care. Some of the specific policies affecting nursing homes include Medicare and Medicaid.  To facilitate better coordination of care, the government has established the HIPPA to prevent patient data misuse. The rule ensures that the patient can provide as much information as possible to guide diagnosis and treatment. When thinking about care coordination, it is crucial to consider the influence of social determinants of health as described in Healthy People 2020. Some of the factors with a huge impact include access to educational, economic, and job opportunities. Overall, ethics are crucial to ensure nurses provide patient-centered care. They ensure that nurses have practice guidelines to follow to meet the set health benchmarks and practice standards.’

Introduction

Ethical and policy factors intersect to promote the required interaction between nurses and patients in care provision. Besides their instrumental role in enabling health care providers to meet the desired health outcomes, ethics are central to ensuring coordination and continuum of care in health care facilities. In the broader health practice, government-based policies and state provisions influence care coordination for patients and communities. As central players in the health practice, nurses’ mandate and conduct are regulated by ethical standards and policies. Since ethics and policy guidelines apply to all nurses irrespective of where they work, knowledge of factors applicable in care coordination is vital in a nursing home.

Government Policies and Coordination of Care

For a long time, several federal policies have greatly influenced the US health care system. Medicare and Medicaid have been among the main policies significantly affecting care coordination. Other programs with a significant impact include the Veterans Health Administration (VHA) and State Children’s Health Insurance Programs (SCHIP). To a huge extent, these policies influence the coordination of care by ensuring that the finances that government allocates to support health care through different programs are spent as expected (Synovitz & Larson, 2018). To improve the desired outcomes, the government implements and update policies regularly to help reduce the illness, disability, and injury burdens.

Specific Policy Affecting the Nursing Home

Medicare

Medicare is among the most notable government policies that influence care coordination in the United States. According to Freed et al. (2021), Medicare is central to health insurance of over 24.1 million individuals in the United States, with the figure expected to increase as time advances. From a coordination point of view, Medicare has improved outcomes by improving access to care for eligible and covered populations. In the same case, residents of Reformed Care Nursing Home should enroll in such programs to help the nation’s health care providers deal with the illness burden effectively. Enrolment in Medicare is a cost-saving approach since it exempts people from the costs associated with unnecessary procedures and tests.

Medicaid

Medicaid is often confused with Medicare, but its spectrum and eligibility criteria differ from Medicare. According to CAP Health Policy Team (2018), Medicaid has expanded insurance services to more than 20 million Americans, and the number is expected to grow progressively, like in the case of Medicare. The program usually covers people from poor backgrounds who require a lot of government support to remain healthy and meet their health care needs. Financed jointly by the states and the federal government, the government-centered policies majorly depend on private health care providers, managed care plans, and community health centers to facilitate coordination of care.

HIPPA

The federal government has implemented policies that protect patient data. Accordingly, patients should not conceal some of their information when seeking health care to enable health care providers to assess them sufficiently and get the medication that addresses their needs.  One of such policies is Health Insurance Portability and Accountability Act (HIPAA). According to Hoffman (2016), the HIPAA rule has three compliance components: administrative, physical security, and technical security requirements. Administrative requirements ensure that data is correct and accessible to authorized parties. Physical security requirements prevent physical theft and loss of devices containing patient information. Technical measures protect networks and devices from data breaches.

Provisions Raising Ethical Questions

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