Health care policy

Overview: For the second milestone of your final project, you will develop a factual overview of your chosen issue, addressing in detail the following elements:

A. Describe the context of the issue.
B. Assess the importance of the issue to the healthcare organization. Provide specific examples of the potential impact of the issue on the organization.
C. Identify the key stakeholders, explaining why these individuals or groups are key stakeholders, and identifying the needs of the specific stakeholders.
D. Explain any critical and reasonable assumptions regarding the stakeholders and provide the reasoning behind these assumptions.

This document should include the three components referenced in Chapter 13 of your textbook: the problem statement, the background

section, and the landscape section. Remember, this is a first draft. You will have the opportunity to incorporate instructor feedback

and revise the factual overview for your final submission in Module Nine.

Guidelines for Submission:Your factual overview should consist of 2–3 pages in length. It should be formatted with 12-point Times New

Roman font, double-spaced, and one-inch margins; formatting of references and in-text citations should follow APA guidelines.

For Milestone Two, you will develop a factual overview of your chosen issue. This document should include the three components

referenced in Chapter 13: the problem statement, the background section, and the landscape section. The factual overview should

represent between one third and half of the policy memorandum. Remember, this is just a draft, so you can revise this document if your

approach changes or you receive substantial feedback from your Instructor.For additional details, please refer to the Milestone Two

Guidelines and Rubric document in the Assignment Guidelines and Rubrics section of the course.

The Health Law and Policy Issue:
Aspen County is in the State of Golden. The State of Golden opted not to participate in Medicaid expansion. Its Medicaid program pays

for services on a fee-for-service basis. The three Aspen County Commissioners largely support the decision not to expand Medicaid. In

general, voters believe that the less government involvement in their lives, the better. Recent Aspen County polling data indicates

that if given an opportunity, voters in Aspen County would like to discontinue all public health services in the county.
Healthcare providers in Aspen County report that their payer mixes are shifting. On average, providers in the area (including Aspen

County Hospital) have traditionally served 1/3 Medicare patients, 1/3 commercial patients, and the remaining percentage split between

Medicaid and uninsured patients. Recently, providers report that they are delivering more uncompensated care and have fewer

commercially insured patients. Providers in for-profit settings are particularly concerned about this development.
Basalt Primary Care, the largest primary care practice in Aspen County, has decided to terminate its uninsured and Medicaid patients.

Basalt Primary Care reports that its doctors can no longer afford to take Medicaid rates or receive no payment for services. Wait times

for Basalt Primary Care’s remaining patient’s average less than one week for the next available appointment. Same-day appointments are

occasionally available.
Other primary care practices report the following average wait times for next available appointments: • 1–2 weeks for commercially

insured patients • 1–2 weeks for patients willing to pay cash up-front for services • 3–5 weeks for Medicare patients • 6–9 weeks for

Medicaid patients
Wait times are rumored to be shorter at school-based clinics and urgent care clinics throughout Aspen County, but no data is collected

about wait times at these facilities.
The federal government has made grant funds available for primary care practices and public health departments to hire enrollment

assisters for up to two years. The assisters go through training (paid for by the grant funds) to help patients enroll in Medicaid or

Medicare, or purchase insurance coverage in a marketplace. The federal government pays salary and benefits for the enrollment

assisters. The only out-of-pocket costs to the primary care practices and public health departments are workspace and supplies. The

grant funds are available directly from the federal government and are independent of any other healthcare reform funds.
You are the director of the Aspen County Public Health Department. The department also serves as a federally qualified health center,

which provides primary care services to uninsured, underinsured, and Medicaid patients. Your board of directors has ordered you to

brief them on the grant funding and recommend a course of action. Specifically, the board chair has asked you to produce a policy

memorandum for the board’s review.


 

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