Discussion 1: Evidence Base in Designs

discussion 1: evidence base in designs

Discussion 1: Evidence Base in Designs

Discussion 1: Evidence Base in Designs

The H. RES. 590 recognizes the month of August as the “National Healthcare Awareness Month” that was introduced to the Congress on August 21st of this year. It is an essential policy, especially this time of the pandemic. People globally have become more health-conscious since the pandemic comes. Health care is not a priority in most of the countries around the globe before the pandemic. However, due to the pandemic, people recognize the importance of eating healthy and staying fit thru exercise.


Although the United States has a better healthcare system than other nations, Americans are still considered unhealthy. According to a new study, few Americans have a lifestyle that is deemed to be healthy. According to new research published in the journal Mayo Clinic Proceedings, less than 3 percent of Americans meet the measurable characteristics that reduce a person’s risks for heart disease (Krans, 2016). Researchers found that only 2.7 percent of the 4,745 participants ages 20 to 85 met all four criteria to be considered for living a healthy lifestyle. Those included: not smoking, eating a diet that aligns with nutritional guidelines, exercising at least 150 minutes a week, or 30 minutes five times a week, keeping a BMI below 20 percent for men and 30 percent for women (Krans, 2016).

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Health literacy is defined as “the capacity of individuals to obtain, interpret and understand basic health information and service, and the competence to use such information and services in ways that enhance health” (Vermont, n.d.).The lack of health awareness is a key component to declining health care. People are unaware of the use of their health insurance in the prevention of illnesses. Furthermore, mental health issues are avoided, and people refuse to acknowledge them.

In evidence-based practice, health education interventions effectively affect culturally and linguistically diverse populations, particularly at improving objective, distal outcomes. These interventions may be equally effective in enhancing proximal patient-reported outcomes (Elsevier, 2021).

If the H. RES. 590 will be passed, it will be a massive help for the government to improve health promotion. Some of the essential highlights from the policy are: to educate Americans on ways health care affects the national community and individual life,  to be more cognizant due to covid 19 pandemic, inform the Americans on the work of their elected representatives in protecting and expanding healthcare and every person should have access to education around health care literacy, be empowered to advocate for health care, and use their voice to make a difference (Congress, n.d.). These are only a few of the advocacy of the said policy.



Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/


Krans, B. (2016). Less Than 3 Percent of Americans Have Healthy Lifestyle. Healthline. Retrived from https://www.healthline.com/health-news/less-than-three-percent-of-americans-have-healthy-lifestyle


Elsevier. (2021). Patient Education and Counseling. Retrieved from https://www.sciencedirect.com/science/article/pii/S0738399121000501


Vermont. (n.d.). Health Education. Retrieved from https://www.education.vermont.gov/student-learning/content-areas/health-education

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

Main Question Post

 Families First Coronavirus Response Act

The Families First Coronavirus Response Act 2020 is a response strategy to the coronavirus outbreak. Particularly, it focuses on the provision of free coronavirus testing, paid sick leave, food assistance, and unemployment benefits. Under the regulation, employers should offer additional protection for clinical care professionals, including personal respiratory protective devices. Through the bill, the federal government seeks to acquire supplemental appropriations to the United States Department of Agriculture (USDA) to increase food assistance and nutrition programs. Specifically, the law guarantees certain waivers for school meal programs and expand Medicaid federal medical assistance percentage (FMAP). The legislation helps to safeguard the populace and enhance emergency preparedness and public health education (Wyte-Lake et al., 2018). The successful implementation of this health policy will necessitate proper coordination of the clinical and social interventions during the pandemic.

Background of the Problem

The coronavirus epidemic has significant adverse effects on the global population. The respective governments ought to formulate and implement robust measures to promote disaster preparedness to counter the prevalence of infection. The Families First Coronavirus Response Act proposes a review of the national budget to increase allocations for the Emergency Food Assistance Program (TEFAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and nutrition assistance grants for U.S territories. The approach is in line with the Global Health Security Agenda (GHSA) for the revamping healthcare sector. In addition, it denotes the commitment of the government to build a strong health system to stop, detect, and contain the spread of illnesses (Gostin, 2017). Therefore, increasing the funding for basic healthcare amenities, screening, and testing for the viruses is in line with the World Health Organization (WHO) directives for ensuring a safer world.

Evidence for the Policy

There is a lot of evidence to support the enactment of the Families First Coronavirus Response Act 2020. Primarily, governments across the world are initiating appropriate measures to ensure containment of the spread of the virus. Some of the key recommendations encompass proper hand hygiene, coughing and/or sneezing in your elbow, working from home, distant learning, social distancing, and staying at least six feet away from one another. However, there are critical implications on the supply of food, drugs, and testing kits. Besides, the federal policymakers are interested in preventing any possible economic downfall. The policy is handy in supporting corporate interventions like providing paid leave for workers and personal protective equipment.

The government has a fundamental responsibility for developing and maintaining healthcare infrastructure and service delivery. Nonetheless, there is always a conflict between public health objectives and industry interests (Collin et al., 2017). The legislators must strive to determine the mechanism to build consensus within and across the sectors of the economy. An integrated policy, such as the Families First Coronavirus Response Act 2020, will help achieve healthcare goals. Furthermore, the legislation will be essential in promoting a synchronized medical response to the virus. It shows the need for a holistic and joint collective approach to eradicating the risk factors for the complication, as well as guaranteeing public and private sector participation in the process.

Families First Coronavirus Response Act 2020 is a government guideline to support the implementation of emergency interventions. The health policy covers the broad areas of healthcare financing and the provision of appropriate clinical services like screening and testing. Also, through the policy, the government proposes to offer subsidies for nutritional and food programs to ensure social distancing and self-quarantine. The policy plays an important role in the attainment of universal healthcare coverage and public safety. Furthermore, its proper enforcement will necessitate coordination of decision planning to accomplish the global and national health goals during this pandemic.


Collin, J., Hill, S. E., Kandlik Eltanani, M., Plotnikova, E., Ralston, R., & Smith, K. E. (2017). Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research. Plos One, 12(9), e0182612. https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0182612

Gostin, L. O. (2017). “America First”: Prospects for Global Health. The Milbank Quarterly, 95(2), 224–228. https://doi-org.ezp.waldenulibrary.org/10.1111/1468-0009.12254

Wyte-Lake, T., Claver, M., Der-Martirosian, C., Davis, D., & Dobalian, A. (2018). Education of elderly patients about emergency preparedness by health care practitioners. American Journal of Public Heath, 108, S207–S208. https://doi-org.ezp.waldenulibrary.org/10.2105/AJPH.2018.304608

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

Hello Dr. D..,

Without a doubt, COVID-19 has blurred the role in public health. On a daily basis, whether it is through watching television, listening to the radio, or scrolling though social media, we are educated by healthcare professionals, the president, the governor, etc. on how to contain this virus – social distancing, hand hygiene, staying 6 feet away from one another, at first wearing a mask if you had a cough, but now requiring individuals to wear a mask whenever in public, no visitations in healthcare settings, and coughing/sneezing in your elbow. Although these are all effective measures to take, there are still dilemmas in efforts to flatten the curve. This pandemic is demonstrating the consequences of underfunding public health. For example, delays in diagnostic testing and results, shortage of personal protective equipment (PPE), and shortage of ventilators. As the federal government scrambles to rapidly boost the nation’s capacity to test for the novel coronavirus, cutting red tape and leaning on the speed and technology of the private sector, new delays are developing because of a shortage of raw materials and vital items: chemical solutions, swabs and even face masks for health-care workers (The Washington Post, 2020). Not as if this is new news, but healthcare professionals are being asked to reuse surgical masks, N95s, surgical caps, etc. Furthermore, the Centers for Disease Control and Prevention (CDC) is recommending wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission (CDC, 2020). This is recommended for our public, in attempts to reserve N95s and surgical masks for healthcare professionals. I believe these measures are put into place, simply because there is a mass shortage of PPE. In addition, I have seen firsthand what delays in diagnostic testing results look like. Thankfully, we have rapid testing, in which individuals receive their results within 24 – 48 hours, but prior results took 5 – 7 days to come back. Unfortunately, some samples were lost, resulting in individuals needing to be re-swapped, contributing to spreading the virus to the community.


Centers for Disease Control and Prevention. (2020). Use of Cloth Face Coverings to Help Slow the Spread of COVID-19.

Retrieved from  https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

The Washington Post. (2020). Shortages of face masks, swabs and basic supplies pose a new challenge to coronavirus

testing. Retrieved from  https://www.washingtonpost.com/climate-environment/2020/03/18/shortages-face-masks-


*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 7 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 7

To participate in this Discussion:

Week 7 Discussion

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion 1: Evidence Base in Designs

Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.

 Chapter 5, “Public Policy Design” (pp. 87–95 only)
 Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp.
 Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
 Chapter 10, “Overview: The Economics and Finance of Health Care” (pp.
183–191 only)

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from

Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and
injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of
Management Review, 21(4), 1055–1080. doi:10.5465/AMR.1996.9704071863

Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems
begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6),

Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the
importance of discretion. Public Management Review, 16(4), 527–547.

Required Media

Laureate Education (Producer). (2018). Getting your Program Designed and Implemented
[Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Health policy and politics [Video file]. Baltimore, MD:

RE: Discussion – Week 7

On February 13, 2020,  H.B. 5886- Vaping Prevention on College Campuses Act of 2020 was introduced to the House (Congress.gov, n.d.). Congressman Eliot Engel introduced the bill due to a recent spike of college students who are vaping. It instructs federal agencies such as the Department of Education and the Department of Health and Human Services to create a toolkit to help colleges reduce e-cigarette use among their students. The kit includes; visual aids related to the hazards of e-cigarette use, teaching resources to prevent use, and a plan to stop use on campus. Additionally, a directory of providers that treat nicotine addiction will be included (Engel authors legislation to reduce vaping on college campuses, 2020).

E-cigarettes heat a liquid turning it into an aerosol that is inhaled into the lung. The fluid may contain substances such as nicotine, tetrahydrocannabinol (THC), and cannabinoid (CBD) oils, flavoring, and additives. In January 2020, the Centers for Disease Control and Prevention (CDC) reported 2,668 hospitalizations or deaths related to e-cigarette, or vaping, product use-associated lung injury (EVALI). Of those cases, thirty-seven percent were age eighteen to twenty-four years old (CDC Centers for Disease Control and Prevention, 2020).

In 2011, e-cigarette use among those aged eighteen to twenty-four was 6.9%; however, in 2014, the usage among this age group rose to 14.3%. This age group stated the main reason they began using e-cigarettes was due to peer pressure. Additionally, this age group believes that e-cigarette use is less detrimental than traditional cigarette use (Wallace & Roche, 2018).

Additional factors that make e-cigarette use popular among the youth include; advertising aimed at the youth, appealing flavors, easy to hide devices, and the ability to provide high levels of nicotine. While the ability to deliver high concentrations of nicotine is attractive to the youth, it is very harmful. Nicotine is very addictive and can impair brain development, which lasts through the mid-twenties (King, Jones, Baldwin, & Briss, 2020).

I believe there is enough evidence to support this bill. The number of injuries or deaths among college-aged students is staggering. The attitudes related to e-cigarettes are detrimental to the well-being of the youth. While the toolkit may not wholly stop e-cigarette use, hopefully, the information will make this age group stop and think about the lasting effects of e-cigarette use.


CDC Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Retrieved April 5, 2020, from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Congress.gov. (n.d.). Retrieved April 5, 2020, from https://www.congress.gov

Engel authors legislation to reduce vaping on college campuses. (2020). Retrieved April 5, 2020, from https://engel.house.gov/latest-news/engel-authors-legislation-to-reduce-vaping-on-college-campuses/

King, B., Jones, C., Baldwin, G., & Briss, P. (2020). The EVALI and youth vaping epidemics- implications for public health. The New England Journal of Medicine, 382(8), 689-691. doi: 10.1056/NEJMp1916171

Wallace, L. & Roche, M. (2018). Vaping in contexts: Links among e-cigarette use, social status, and peer influence for college students. Journal of Drug Education, 48(1/2), 33-53. doi: 10.1177/0047237918807706

RE: Discussion – Week 7


Hi J…,

I enjoyed reading your post. While this legislation deals mainly with college campuses, it would be wonderful to see it expanded into middle school and high school-aged children as well. The FDA and CDC reported in 2018, over 3.6 million kids used e-cigarettes (Products, C. for T., 2018). I agree that this topic should be addressed to college-age as well, however, many of them begin using this product in middle school and high school. So, if we can educate them on the risks involved at a younger age, perhaps we can make a greater difference. Many people believe vaping is a safer alternative to smoking. Therefore, educating young people about all the dangers of vaping might get them to seek a safer or healthier alternative.

Nicotine is a highly addictive and toxic chemical that causes blood pressure and adrenaline spikes, which raises heart rates and increases the potential for heart attacks and strokes (Blaha, M. J., n.d.). Some studies suggest nicotine may even be as addictive as heroin and cocaine (Blaha, M. J., n.d.). E-cigarettes can administer higher levels of nicotine than actual tobacco products due to the ability to purchase different strengths of nicotine for vaping (Blaha, M. J., n.d.). Other factors as well make e-cigarettes appealing to young people. They often cost less than traditional cigarettes or other tobacco products (Blaha, M. J., n.d.). Also, these vaping products come in a wide variety of flavors like watermelon and apple, which appeals to younger people (Blaha, M. J., n.d.). In 2015, the US Surgeon General reported a 900% increase of high school kids vaping and 40% had never used traditional tobacco products before (Blaha, M. J., n.d.).

This information alone is enough evidence for legislation to be enacted to get the word out to young people about this dangerous practice and that it is not a safe alternative to traditional cigarette smoking.


Blaha, M. J. (n.d.). 5 Vaping Facts You Need to Know. Retrieved April 8, 2020, from https://www.hopkinsmedicine.org/health/


Engel, & L., E. (2020, February 13). Text – H.R.5886 – 116th Congress (2019-2020): Vaping Prevention on College Campuses

Act of 2020. Retrieved April 8, 2020, from https://www.congress.gov/bill/116th-congress/house-bill/5886/text?r=43&s=1

Products, C. for T. (2018). 2018 NYTS Data: A Startling Rise in Youth E-cigarette Use. Retrieved April 8, 2020, from


Support for health and wellness coaches is needed to pass H.Res. 481 (2021). Representative Donald Payne introduced this recently on June 16, 2021. He has eight cosponsors that support the need for this bill. S. Res. 272, an identical bill has been presented to the Senate for approval by representative Martin Heinrich (2021).

The bill that I chose is H.R. 1109- Mental Health Services for Students Act of 2020 and it was passed on September 29, 2020 and the purpose of this is act is to amend the Public Health Service Act to revise and extend projects relating to children and to provide access to school-based comprehensive mental heath programs (Napolitano, G. F., 2020). The bill intends to provide more than $130,000,000 in grants and it has plans to extend the scope of Project Advancing Wellness and Resilience Education (AWARE) program by including on site licensed mental health professionals in school all across the country and the funding will be distributed by the Substance Abuse and Mental Health Services Administration (SAMHSA) which will help set guidelines and measure the outcomes for the program (Facts on the Mental Health Services for Students Act, 2021). It will also help promote positive mental health education and support for parents, siblings, and family members with children who are suffer from mental health disorders and it helps teachers focus on teaching by providing comprehensive and linguistically appropriate services to children with mental health (Facts on the Mental Health Services for Students Act, 2021). 

I believe that this is a great bill that has been passed because mental health is a topic that is often overlooked, especially mental health in younger kids and they are often viewed as the vulnerable population. Data shows that in the U.S, 1 in 6 youth aged 6-17 experience a mental health disorder and 49.4% of children with a mental health disorder do not receive needed treatment from a mental health professional and suicide is the second leading cause of death among adolescents with mental disorders (Facts on the Mental Health Services for Students Act, 2021). Also, as the years go on it was found that between March 2020, and October 2020 there was been a 24% increase in nationwide mental health related emergency room visits among children of the age of 5-11 and 31% between the ages of 12-17 since the year 2019. And with this big increase, it also correlate to the increase of youth entering juvenile justice system, at least 50%-75% of these youth meet the criteria for mental health disorder (Facts on the Mental Health Services for Students Act, 2021). 

As healthcare providers it is important for us to understand policies and what we can do to help advocate for our patients. Advocacy is believed to be the pillar of nursing, nurses tend to instinctively advocate for their patients in their work environment and in their communities (American Nurses Association, n.d). When nurses advocate for their patients this helps provide better care and allow for change in the communities and allows care to be provide more efficiently and safer. 


American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/

Facts on the Mental Health Services for Students Act. (2021, May 14). https://napolitano.house.gov/issues/hr-721-mental-health-services-students-act/facts-mental-health-services-students-act. 

Napolitano, G. F. (2020, September 30). H.R.1109 – 116th Congress (2019-2020): Mental Health Services for Students Act of 2020. https://www.congress.gov/bill/116th-congress/house-bill/1109/text. 

Wellness and health coaches must be mindful and compassionate to assist clients dealing with chronic diseases (Kennel, 2018).   A connection to the client, client motivation, and confidence will need to be expressed by the coach to assist the client in making a change (Sforzo et al, 2015). These coaches will assist the client in a holistic approach to improve their health.  Health and wellness coaches need H. Res 481  and S.Res  272 approval to continue to be a vital role in the progression of consumers’ holistic, physical,  and overall health(2021).

According to the National Board for Health and Wellness Coaching (NBHWN), these individuals will be certified through the national board. Practitioners that have an interest in this will need to complete a training program, 50 coaching sessions, and have an associate’s degree or the equivalent of 4000 hours working experience. Once these items are completed, then they will be eligible to sit for an exam.

Many studies have been conducted to show the benefits of health and wellness coaches. Julie Kennel reported in her review 9.6% of participants who contributed to health and wellness coaching lost weight at 6 months as compared to the mentor group losing 5.7% (2018). Many more Americans would be able to benefit from health and wellness coaches with the support of congress.


H.Res. 481 -117th Congress. (2021). Expressing support for health and wellness coaches.  https://www.congress.gov/bill/117th-congress/house-resolution/481?q=%7B%22search%22%3A%5B%22H.res+481%22%5D%7D&s=3&r=1.

Kennel, J. (2018). American Journal of Lifestyle Medicine. Health and Wellness Coaching Improves Weight and Nutrition Behaviors 12(6): 448-450. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367877/.

National Board for Health and Wellness Coaching. (2021). About. https://nbhwc.org/about/

  1. Res . 272- 117th Congress. (2021). A resolution expressing support for health and wellness coaches. https://www.congress.gov/bill/117th-congress/senate-resolution/272?q=%7B%22search%22%3A%5B%22s.+272%22%5D%7D&s=1&r=3.

Sforzo, G, Morrse, M and Scholtz, M.  (2015). ACSM’s Health & Fitness Journal. Delivering Change That Lasts: Helath and Wellness Coaching Competencies for Exercise Professionals. 19(2):20-26. https://journals.lww.com/acsmhealthfitness/Fulltext/2015/03000/DELIVERING_CHANGE_THAT_LASTS__Health_and_Wellness.8.aspx.

            I currently work as a school nurse and one of my major job duties is to ensure students are compliant with the state’s required vaccinations. Currently, the human papillomavirus vaccine (HPV) is recommended but not required in my state. On March 03, 2021 Republican Kathy Castor introduced bill H.R. 1550 to the 117th Congress. This bill aims to increase HPV vaccination rates and prevent other cancers associated with this virus (117th Congress, 2021). This particular bill caught my attention as I have encountered many parents who are not well informed on HPV and due to this opt out of having their children vaccinated. Part of this bill would direct the Centers for Disease Control and Prevention (CDC) to educate the public about HPV vaccinations and it also directs the National Cancer Institute to expand research on HPV associated cancers (117th Congress, 2021).

            I believe this bill should be supported as it aims to provide a public awareness campaign that can significantly reduce the number of cancer cases caused by HPV. The Centers for Disease Control and Prevention reports that each year 35,900 women and men are estimated to be diagnosed with a cancer caused by HPV (Centers for Disease Control and Prevention, 2021).  The CDC also reports the HPV vaccination could prevent more than 90% of cancers caused by this virus (CDC,2021). This is 33,00 cases that can be prevented. It is important for the public to be educated on this vaccine as the National Canter Institute has found this vaccine to be safe and has caused no serious side effects (NCI, 2021). The results clearly outweigh the risks and parents and adults need to be aware of the major health benefit involved in receiving this vaccine.


117th Congress. (2021). H.R 1550. Washington, D.C. Retrieved July 18, 2021 from Committees – H.R.1550 – 117th Congress (2021-2022): PREVENT HPV Cancers Act of 2021 | Congress.gov |        Library of Congress

Centers for Disease Control and Prevention, (2021).  Human Paillomavirus (HPV).  Retrieved July 18, 2021 from HPV Cancers are Preventable | CDC

National Cancer Institute, (2021). Human Papillomavirus (HPV) Vaccines. Retrieved July 18,2021 from  https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious- agents/hpv-vaccine-fact-sheet

The Office of the Inspector General of the Department of Health and Human Services and the Attorney General are required under this measure to submit a yearly report on healthcare fraud that targets elderly citizens to Congress and the general public(Congress.govLinks to an external site. (n.d.). The information must list the ten most common healthcare fraud schemes that prey on elders, the measures to stop them, and policy recommendations to strengthen senior protection. The report can leave out facts or data that jeopardize ongoing investigations or benefit criminals over the elderly.
The information must be published on specific government websites and distributed, as required, to Medicare beneficiaries.
Healthcare fraud is a serious issue that affects people of all ages, but it mainly targets vulnerable groups like older adults. Scammers and dishonest organizations use older adults’ trust and ignorance to trick them into paying for needless or false medical treatments, prescriptions, or health insurance policies. These unethical practices may result in financial damage, health problems, and declining public confidence in the healthcare system.
Social Determinants
Age-related problems for older people include declining physical health, financial burden, and cognitive deterioration. Seniors are also more likely to be victims of elder abuse, such as financial fraud that target older adults. Knowing that family members carry out 90% of scams targeting senior citizens is crucial. Low-income elders are among the older adults vulnerable to financial scams. Age is the social characteristic that has the most significant impact on this policy. People may experience physical, cognitive, and emotional problems as they age, which increases their vulnerability to healthcare fraud. Furthermore, older adults use healthcare services more frequently, increasing their exposure to potential scams.
The evidence base to support
A substantial body of research supports the necessity for regulations to safeguard senior citizens against healthcare fraud. The prevalence and effects of healthcare fraud on older individuals have been the subject of numerous studies and reports. For instance, according to a Federal Trade Commission (FTC) report, persons 60 and older were more likely than younger adults to report losing money to fraud in 2020, with a median loss of $800—Federal Trade Commission(n.d). One of the main tools used by the government to combat Medicare and Medicaid fraud by nursing homes is the Civil False Claims Act (FCA), a general federal fraud legislation.FCA accountability requires evidence that a party submitted a false or fraudulent claim to the federal government with knowledge of it. FCA violators are susceptible to severe civil penalties, including treble damages and fines ranging from $5,500 to $11,000 for each fraudulent claim. (Gittler, 2008)
According to the Older Americans Act, long-term care ombudsman programs (LTCOPs) can receive federal financial support from the federal government (Gittler, 2008). State LTCOPs have a comprehensive general responsibility to promote the health, safety, well-being, and rights of residents of nursing homes and other long-term care institutions under the Older Americans Act.
The Act specifically mandates that the state LTCOPs represent specific nursing home patients. Investigation and resolution of complaints, especially regarding the quality of care presented by or on behalf of nursing home residents, is one of their primary duties in individual advocacy.

Additionally, studies have demonstrated that implementing healthcare fraud prevention measures like education and awareness campaigns, stronger laws, and increased enforcement can effectively lower fraud and safeguard seniors.


Congress.govLinks to an external site. (n.d.). Retrieved July 12, 2023, from https://www.congress.gov/

Links to an external site.

Federal Trade Commission. (n.d). Retrieved July 12, 2023, https://www.ftc.gov/system/files/ftc_gov/pdf/P144400OlderConsumersReportFY22.pdf

Gittler, J. (2008). Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: A survey of federal and state laws. Research in Gerontological Nursing, 1(4), 264–284. https://doi.org/10.3928/19404921-20081001-08

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