Assessing A Healthcare Program/Policy Evaluation NURS 6050

Better Choices Better Health Diabetes (BCBH-D) Self-Management Program.

• BCBH-D program is an all-online workshop.
• Participants of the program logged on at their convenience to learn about:
• Healthy eating and menu planning.
• Managing blood glucose (Turner et al., 2018).
• Strategies to address problems such as frustration, fatigue, and isolation.
• Appropriate exercise for controlling blood glucose and maintaining and improving strength, flexibility, and endurance (Turner et al., 2018).
• Appropriate use of Diabetes medications.
• Communicating effectively with family, friends, and health professionals (Turner et al., 2018).
• Goal-setting.
• Disease-related problem-solving.
• The program ran for six weeks, with new lessons being posted every week. The participants logged on 2-3 times per week for a total of 1-2 hours (Turner et al., 2018).

• The success of the BCBH-D program was measured by its impact on comorbid illness attributed to DM, Health care utilization, and Health care costs within 12 months after establishing the program (Turner et al., 2018).
• The impact was compared with a propensity score-matched control cohort of DM patients who were provided usual care but did not participate in the BCBH-D program.

• The BCBH-D program reached 558 persons with Diabetes Mellitus.
• The health program had a significant impact since the participants had a reduced all-cause health care utilization and medical costs (Turner et al., 2018).
• The impact realized with the BCBH-D program include:
• Decreased all-cause utilization.
• Reduced ED visits and outpatient visits (Turner et al., 2018).
• Decreased unadjusted total all-cause medical cost by $2207 (Turner et al., 2018).
• Direct cost savings of the BCBH-D were $815.

• Outcome evaluation data included pre-and post-intervention all-cause and diabetes-specific utilization and costs.
• Diabetes-specific utilization referred to hospitalizations and ED visits with a primary diagnosis of Diabetes (Turner et al., 2018).
• It also includes outpatient services such as office visits, laboratory tests, imaging, and procedures with any diabetes diagnosis on the claim.
• All-cause utilization referred to any claims-based health care utilization inclusive of Diabetes and any other diagnosis on the claim (Turner et al., 2018).
• All-cause and Diabetes specific utilization data for the 12-month pre-and post-intervention periods included ED visits, hospitalizations, and outpatient services, reported as visits per 1000 participants (Turner et al., 2018).

• Stakeholders identified in the evaluation of the BCBH-D program include persons diagnosed with Diabetes mellitus (Turner et al., 2018).
• Patients with Diabetes would benefit the most from the results and reporting of the BCBH-D program (Turner et al., 2018).
• The program’s impact would influence the development of other Diabetes self-management programs, which would help reduce healthcare utilization and costs for diabetic patients.
• DM patients would also benefit from improved health outcomes such as controlled glycemic levels, reduced DM comorbidities, and reduced DM-related complications.

• The original goal of the BCBH-D self-management program was to reduce healthcare utilization and healthcare costs attributed to the management of Diabetes (Turner et al., 2018).
• The program adequately met its goal, as evidenced by results showing that participants in the peer-facilitated BCBH-D program experienced decreased all-cause health care utilization and medical costs (Turner et al., 2018).
• Based on the results, there was a significant decrease in all-cause utilization and costs for the participants for ED, inpatient, and outpatient services.
• There was also a decrease in total all-cause medical and pharmacy costs (Turner et al., 2018).
• There was a decreased utilization in the participants for DM comorbid chronic conditions.
• Notably, there were reduced claims for hyperlipidemia, hypertension, and depression among participants in the BCBH-D program during the follow-up period (Turner et al., 2018).

• I would highly recommend implementing a health program similar to the BCBH-D Self-Management Program in my current healthcare organization.
• Implementation of the program would significantly reduce healthcare costs used in the management of DM, which has the highest expenditures (Adam et al., 2018).
• It would also reduce ED visits and hospitalizations of patients and thus enable the organization to channel the resources to manage other conditions.
• I recommend the program because it would significantly improve health outcomes for persons with DM, who have one of the worst morbidity and mortality rates in our healthcare setting and other healthcare systems (Adam et al., 2018).

• Disseminating a program evaluation, particularly a program that extends over to the public health pyramid, to interdisciplinary health care audiences interested in the health problem or interventions used to address the health problem (Issel, 2016).
• Nurse advocates can also submit a health program’s evaluation reports to a myriad of health journals. This can inform other health providers and organizations of the program’s impact in improving health outcomes and efficiencies in patient care, influencing them to implement similar programs (Issel, 2016).

• The BCBH-D Self-Management Program is an ideal healthcare program that should be implemented in all healthcare organizations providing care to diabetes patients.

• Similar programs can also be established to include patients with other chronic or lifestyle conditions such as hypertension, heart failure, hyperlipidemia, and obesity.
• The State governments should facilitate health care organizations to establish such programs through funding and mobilization to help improve health outcomes in the population and lower health care costs.

Healthcare Program/Policy Evaluation

Affordable Care Act 2010 Policy

Description

The aim of the policy is to increase the number of individuals covered by medical insurance. The policy also aims at improving the quality of medical care and costs.

How was the success of the program or policy measured?

The success of the policy is measures using health insurance companies and effects on the number of individuals with health insurance. These firms reported an increase in enrollment based on estimated projections by the policy (Courtemanche et al., 2018). For instance, the rate of uninsured individuals dropped by close to 20% since the policy’s enactment.

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

Over 20 million people that were never insured got covered through the Affordable Care Act. These include individuals with pre-existing conditions (Sommers et al., 2017). The uninsured levels fell in all levels of income, households, level of education and among the various ethnic groups. The issue of paying bills was resolved as more people who did not visit healthcare providers dropped with more accessing care interventions.

What data was used to conduct the program or policy evaluation?

The enactment of ACA policy was based on the declining rates of employer-based insurance coverage and an increase in the number of individuals without medical insurance. For instance, the level of uninsured nonelderly individuals was a concern as soon as their parents’ coverage stopped due to high cost of insurance premiums.

What specific information on unintended consequences were identified?

The insured will have limited access to healthcare providers and get sub-standard service since only a small number of providers will accept lower rates than those in the private market. Healthy young adults were mandated to buy extensive policies without any need due to subsidies for the uninsured. The plan leaves limited options for the participants and discourages entry of new players as they cannot dictate prices which reduces competitiveness.

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 involved stakeholder in policy evaluation included state and federal government and agencies, health insurance firms, political leaders, the Supreme court and the public.

The main beneficiaries of the policy include young adults since the premiums were reduced to allow them purchase insurance coverage (Milstead & Short, 2019). Irrespective of the ethnic group, income or education level, everyone would benefit from the policy upon enrollment due to the lower rates of premium.

Did the program or policy meet the original intent and objectives? Why or why not?

The Affordable Care Act 2010 met its original intent and objectives since the number of uninsured individuals and households dropped significantly. The policy subsidized insurance premium rates. Insurance companies reported improved enrollment rates while hospitals recorded a rise in the number of visits by patients covered for different health care needs (Sommers et al., 2017). The policy’s ability to increase health insurance markets and options is considered as a fundamental part of its effectiveness and attaining intended objectives.

Would you recommend implementing this program or policy in your place of work? Why or why not?

Yes, I would highly recommend the policy in my workplace because of the benefits that it offers to employees and even employers. The policy promotes health through subsidized insurance premiums that allow individuals with pre-existing conditions to enroll and get medical care. The policy promotes primary care interventions as individuals can access healthcare services for reviews and screening (Courtemanche et al., 2018). The policy also demonstrates the need for state and federal governments to understand the importance of health insurance coverage in reducing the cost of healthcare.

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.

As a nurse advocate, evaluation of the policy is essential, especially its outcomes and impacts on the targeted populations. In this case, the policy had intended and unintended consequences and its evaluation is important in informing better interventions to address the negative effects. Through the evaluation, one makes a comparison on outcomes and anticipated results to ascertain the difference (Laureate Education, 2018). Secondly, evaluation of cost and benefit is essential as it demonstrates the overall economic viability and sustainability of the policy, particularly in the long-term (Williams & Anderson, 2018). Cost-benefit analysis and cost-effectiveness studies cane be critical in understanding the effects of the policy.

General Notes/Comments

The enactment of the ACA 2010 remains a historic and landmark decision that transformed healthcare forever and ensured that more Americans could access better health interventions. The positive effects of ACA 2010 are critical for cost-reduction efforts and quality of care. Conversely, the act has unintended effects like reduced competitiveness of the healthcare environment. However, the policy remains a critical part of enhancing quality care and affordable health in the country.

Based on the program or policy evaluation you seelcted, 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 time in program implementation was the program or policy evaluation conducted?

Using sufficient evidence, response clearly and accurately describes the healthcare program or policy outcomes.

Response accurately and clearly explains how the success of the program or policy was measured.

Response accurately and clearly describes how many people were reached by the program or policy and accurately describes the impact of the program or policy.

Response accurately and clearly indicates the point at which time the program or policy evaluation was conducted.

Using sufficient evidence, response accurately describes the healthcare program or policy outcomes.

Response accurately explains how the success of the program or policy was measured.

Response accurately describes how many people were reached by the program or policy and accurately describes the impact of the program or policy.

Response accurately indicates the point at which time the program or policy evaluation was conducted.

Description of the healthcare program or policy outcomes is inaccurate or incomplete.

Explanation of how the success of the program or policy was measured is inaccurate or incomplete.

Description of how many people were reached by the program or policy and the impact is vague or inaccurate.

Response vaguely describes the point at which the program or policy evaluation was conducted.

Description of the healthcare program or policy outcomes is inaccurate and incomplete or is missing.

Explanation of how the success of the program or policy was measured is inaccurate and incomplete or is missing.

Description of how many people were reached by the program or policy and the associated impacts is vague and inaccurate or is missing.

Response of the point at which time the program or policy was conducted is missing.

·   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 the 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.

Response clearly and thoroughly explains in detail: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program met the original intent and outcomes, including an accurate and detailed explanation of the reasons supporting why or why not. -whether the program should be implemented, including an accurate and detailed explanation of the reasons supporting why or why not. -at least two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation.

Using sufficient evidence, response accurately identifies the data used to conduct the program or policy evaluation. Response explains in detail specific information on outcomes and unintended consequences identified through the program or policy evaluation. Response explains in detail the stakeholders involved in the program or policy evaluation. Response explains who would benefit most from the results and reporting of the program or policy evaluation. Response includes an accurate explanation of whether the program met the original intent and outcomes, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of whether the program should be implemented, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation.

Response vaguely or inaccurately identifies the data used to conduct the program or policy evaluation. Explanation of specific information on outcomes and unintended consequences identified through the program or policy evaluation is vague or incomplete. Explanation of the stakeholders involved in the program or policy evaluation is vague or inaccurate. Explanation of who would benefit most from the results and reporting of the program or policy evaluation is vague or inaccurate. Explanation of whether the program/policy met the original intent and outcomes, and the reasons why or why not is incomplete or inaccurate. Explanation of whether the program or policy should be implemented, and the reasons why or why not, is incomplete or inaccurate. Explanation of ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation is incomplete or inaccurate.

Identification of the data used to conduct the program or policy evaluation is vague and inaccurate or is missing. Response includes vague and incomplete or is missing explanation of: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program or policy met the original intent and outcomes, and the reasons why or why not. -whether the program or policy should be implemented, and the reasons why or why not. -ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation.

Paragraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.
Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

Purpose, introduction, and conclusion of the assignment is incomplete or missing.

Correct grammar, mechanics, and proper punctuation

Uses correct grammar, spelling, and punctuation with no errors.

Contains a few (1-2) grammar, spelling, and punctuation errors.

Contains several (3-4) grammar, spelling, and punctuation errors.

Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

The paper follows correct APA format for title page, font, spacing, parenthetical/in-text citations, and reference list).

Uses correct APA format with no errors.

Contains a few (1-2) APA format errors.

Contains several (3-4) APA format errors.

Contains many (≥5) APA format errors.

Hospital Readmissions Reduction Program (HRRP)

The program was successful in terms of reducing cases of readmission and promoting better care given to the patients. Readmission cases also significantly reduced across the country hence saving the CMS a lot of money.

The program utilized the costs incurred as a result of readmission based on diseases that were best preventable through the guidance of nurses and doctors as well as good communication between patients and nurses (Gai & Pachamanova, 2019).

The stakeholders identified patients, nurses, doctors, and insurance firms. The people who benefited more are patients and insurance healthcare firms (McIlvennan, Eapen  & Allen, 2015). For instance, nurses were given extra work of educating patients while insurance firms were able to save on money spend on readmissions.

The program met the original intended objective of reducing readmissions.

I recommend implementing the policy in every healthcare facility since it is in line with preventive care which is much cheaper and safer for all people.