Policy Evaluation Analysis Assignment Instructions
Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
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 Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
Describe the healthcare program or policy outcomes.
How was the success of the program or policy measured?
How many people were reached by the program or policy selected?
How much of an impact was realized with the program or policy selected?
At what point in program implementation was the program or policy evaluation conducted?
What data was used to conduct the program or policy evaluation?
What specific information on unintended consequences was identified?
What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
Did the program or policy meet the original intent and objectives? Why or why not?
Would you recommend implementing this program or policy in your place of work? Why or why not?
Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
Solution
Healthcare Program/Policy Evaluation Analysis
| Healthcare Program/Policy Evaluation Analysis | Medicare healthcare program |
| Description | Medicare, instated in 1965 and currently managed by the Centers for Medicare and Medicaid Services (previously under the social security administration), serves as a nationwide health insurance initiative. Primarily catering to individuals aged 65 and above, it also extends coverage to younger individuals dealing with disabilities, end-stage renal disease, and amyotrophic lateral sclerosis (Medicare Payment Advisory Commission, & Book, 2012). Comprising four key components, the program addresses specific services: part A focuses on hospital insurance for inpatient care, part B covers medical insurance for doctor services and outpatient care, part C offers an alternative managed Medicare allowing patients to select health plans covered by either part A or B, and part D provides prescription drug coverage. |
| How was the success of the program or policy measured? | Evaluating the effectiveness of Medicare, a program focused on long-term healthcare, involves a thorough examination over time, with emphasis on quality assessment. One method employed is the use of episode-based quality measurement, which gauges the program’s attainment of specific objectives. This approach allows for the evaluation of physicians and care teams involved in patient care, particularly for individuals dealing with multiple chronic diseases. Episode-based quality measurements specifically take into account the various episodes of illness, especially in cases of chronic conditions. The program also incorporates other measurement types, including condition-based measures, procedure-based measures, primary prevention measures, and overall health status assessments. By employing these measures systematically, the success of the Medicare program can be comprehensively evaluated. |
| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? | As per the 2019 Medicare trustee report, the Medicare program has extended health insurance coverage to approximately 59.9 million individuals. Of this total, around 52 million are individuals aged 65 and older, while about 8 million are younger individuals and those grappling with chronic illnesses. The noteworthy impact of the program is evident in government spending, which reached approximately $776.2 billion in 2020, marking a significant increase since its establishment in 1965. Currently, only about 2% of the elderly population lacks coverage under the Medicare insurance program, a remarkable improvement from the 48% who lacked medical insurance at the program’s inception. Notably, the availability of quality healthcare services and financial coverage provided by the program has contributed to a noteworthy 15% increase in the life expectancy of Americans aged 65 and above. |
| At what point in program implementation was the program or policy evaluation conducted? | The initial assessment of the Medicare program occurred in 1979, approximately 14 years after its establishment. At that time, enrollment was relatively modest, with around 521,894 beneficiaries. Recognizing the need for increased participation, the program underwent enhancements through the involvement of Health Maintenance Organizations and financial incentives. This approach resulted in the incorporation of additional health plans, thereby attracting a greater number of enrollees (King, et.al, 2011). However, it’s essential to note that the evaluation of the program is an ongoing process, marked by the provision of annual reports detailing its successes and advancements. This continuous evaluation is imperative due to the program’s nature as a long-term healthcare initiative. |
| What data was used to conduct the program or policy evaluation? | The yearly enrollment figures serve as a key metric for assessing the overall success of the Medicare program. In its early stages, only approximately 521,894 older individuals had enrolled. Contrasting this with the current enrollment figure of around 59.9 billion people represents a significant 48% increase, underscoring the program’s growth and effectiveness (King, et.al, 2011). However, the evaluation of the program’s success extends beyond enrollment numbers. It also involves comprehensive assessments of the quality of healthcare services delivered in facilities catering to Medicare enrollees. By considering both enrollment trends and the quality of healthcare provided, a more holistic evaluation of the program’s success can be achieved. |
| What specific information on unintended consequences was identified? | A significant unintended consequence of the Medicare program is the annual escalation in federal expenditure, primarily driven by the continuous growth in Medicare enrollees. In 2008, Medicare costs reached approximately $386 billion, constituting 13% of the federal budget. This proportion is expected to rise in the subsequent years, influenced by the ongoing increase in healthcare costs and the overall economic conditions of the country. As more individuals enroll in Medicare, the financial burden on the federal budget continues to expand, becoming a noteworthy unintended outcome of the program. |
| What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. | The primary stakeholders in the Medicare program include the elderly population, whose participation significantly influences the program’s success. Increased enrollment by the elderly contributes to a healthier aging population. Healthcare facilities are also crucial stakeholders, collaborating with the insurance program to deliver quality healthcare services as mandated by the program (Langwell, & Hadley, 1989). The government is a key player, as it takes on the responsibility of financing the insurance program to cover all enrolled individuals and maintain the health facilities. Families of Medicare enrollees stand to benefit, as the insurance program alleviates the financial burden associated with expensive healthcare services and chronic diseases that are prevalent among the elderly. Furthermore, the government benefits from reduced dependency levels, stemming from lower healthcare costs and diminished financial strain in treating chronic illnesses in the elderly. Healthcare costs are a significant contributor to increased poverty levels, and the Medicare program helps mitigate this impact. |
| Did the program or policy meet the original intent and objectives? Why or why not? | Yes, the Medicare program has successfully achieved its original objective of promoting a healthier elderly population, as evidenced by the notable 15% increase in life expectancy among individuals aged 65 and above. This outcome underscores the positive impact of the program in enhancing the overall health and well-being of the elderly, fulfilling its fundamental goal of providing essential healthcare coverage and support to this demographic. |
| Would you recommend implementing this program or policy in your place of work? Why or why not? | Certainly, I would endorse the implementation of the program as it would guarantee that senior individuals in the workplace have access to high-quality healthcare without experiencing the adverse impact of financial burdens to meet healthcare expenses. |
| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation. | Nurses play a crucial role in the Medicare program by actively participating in data collection, particularly in healthcare institutions that deal with common chronic illnesses affecting the elderly. Their involvement in data collection contributes to the evaluation of the program, helping to tailor individualized insurance plans based on specific healthcare needs. Furthermore, nurses can provide valuable perspectives on addressing identified issues within the healthcare industry related to the program. This may involve proposing and advocating for policies aimed at improving the delivery of healthcare services to the elderly population covered by Medicare. By leveraging their expertise and insights, nurses contribute significantly to the ongoing success and refinement of the Medicare program. |
| General Notes/Comments | Indeed, the Medicare program has been advantageous to the population, particularly in the context of addressing high healthcare costs and contributing to economic stability. By providing health insurance coverage to the elderly population, Medicare ensures that this demographic is adequately supported within the healthcare system. This not only alleviates financial burdens associated with healthcare but also promotes overall well-being among the elderly. Additionally, by assisting in the management of healthcare expenses for seniors, Medicare helps prevent potential economic strains on individuals and families, contributing to a more stable and resilient economy. Overall, the program serves as a crucial component in promoting health equity and financial security for the elderly population. |
References
Langwell, K. M., & Hadley, J. P. (1989). Evaluation of the Medicare competition demonstrations. Health Care Financing Review, 11(2), 65.
Medicare Payment Advisory Commission, & Book, A. D. (2012). Healthcare Spending and the Medicare Program. Washington, DC: MedPAC)(June 2019).
Centers for Medicare & Medicaid Services (CMS), HHS. (2011). Medicare program; Medicare shared savings program: Accountable care organizations. Final rule. Federal Register, 76(212), 67802-67990.
King, G., Nielsen, R., Coberley, C., Pope, J. E., & Wells, A. (2011). Avoiding randomization failure in program evaluation, with application to the Medicare Health Support program. Population Health Management, 14(S1), S-11.