Changing healthcare policy

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We know the decisions made by policymakers in Washington and in state capitals across the country have a profound impact on our industry. The federal and state governments are perhaps the largest consumers of health care in the country and health care makes up nearly one quarter of U. So it's not hard to understand why policymakers devote so much attention to the health care industry. There is the ongoing debate about whether the government is too involved in health care or not enough, about whether we spend too much on health care, or not enough.

But that's not the point. The point is that the government is involved in health care and it's going to continue to be involved in health care. We can choose not to be interested in government and politics, but government and politics are interested in us. Withdrawing, or being angry or frustrated won't make them go away.

Well I grew up as a hockey player and I can tell you that the only thing worse than skating to where the puck has been is to stand flat-footed and wait for the puck to come to you.

As business people, we can either passively accept the policy and regulatory climate that comes our way, or we can get involved and try to do something about it. At McKesson, we track thousands of pieces of legislation, and regulations affecting our business and our customers. One of the remarkable things about health care is how often policy debates can devolve into a zero sum game pitting one part of the industry against the other. Payers vs. When we allow these siloed debates to divide us, not only does it mean somebody wins, and somebody loses but we all lose.

The people who end up winning are the cynics who don't want to see any progress at all. We have to rise above our narrow financial interests and work together to support each other and advocate for the policies that are good for the health care system as a whole, and good for patients. We can argue that it's unfair that physicians are being overpaid for basic health care services that could easily be done by a pharmacist for less money, and more conveniently for patients.

But to make the argument that way is going to end up with the doctors being pitted against the pharmacists. This can include situations like abuse towards medical staff, patient abductions or elopements, theft, and active shooters.

Aside from physical security, data privacy and technology security policies and procedures are extremely important in any healthcare facility. The HIPAA Privacy Rule protects patient information from release to the public, while permitting the exchange of this information if needed between medical professionals and in certain other situations.

Alex M. The more that technology becomes an integral component in how healthcare facilities operate, the greater the chance that data leaks and privacy breaches can occur. In , there were healthcare breaches, a 55 percent increase from For many families, healthcare takes up a huge portion of their budget. There is an ongoing debate over who has access to coverage and why the costs of care are so high in the United States, which is why some policymakers are trying to find solutions to improve access to affordable and quality care for all.

Below, we explore a few major health policy issues impacting Americans today. In , 92 percent of Americans had some form of healthcare coverage—whether employer-provided coverage, Medicare or Medicaid, or private health insurance. Katherine Keisler-Starkey and Lisa N.

The Affordable Care Act, implemented in , played a major role in increasing the number of insured Americans. Although the percentage of uninsured individuals has decreased, policymakers have diverging viewpoints around this issue. Some policymakers are pushing for higher participation in employer-provided coverage, while others are advocating for Medicare for all.

Even with health insurance, many individuals still face overwhelmingly high out-of-pocket healthcare costs. In the wake of the COVID pandemic, it has become even more imperative for lawmakers to find an affordable solution for Americans. To address these high costs, policymakers have discussed finding a way to lower prices without compromising the quality of the services and care provided. Some solutions include significantly reducing prescription drug prices or allowing policymakers to regulate healthcare prices.

And competing with the public option could pressure private insurers to lower their costs. This includes access to healthy food, affordable housing, transportation, childcare services, education, and more. A healthy population leads to better outcomes and more affordable care for all. Healthcare policy analysts play a huge role in making effective changes to our healthcare systems.

They are responsible for evaluating current policies and suggesting improvements that can impact patient care. These analysts use critical thinking skills to compile and evaluate relevant data and research, suggest changes to current policies, and create new policy proposals. Most healthcare policy analysts start by earning an undergraduate degree in public health, public policy, political science, government, or a related field.

Nurse practitioners NPs can also play an important role in healthcare policy. NPs and other nurses can help identify problems within the current healthcare system, come up with solutions, and suggest new policies that can positively impact the well-being and safety of their patients.

You can also earn a role specialty as a family nurse practitioner. Healthcare policy is important on a macro and micro level. It affects our whole society, as well as each community and facility where care is administered. The University of St. The MSN has several options to accelerate your time to degree completion.

Earn your advanced nursing degree while keeping your work and life in balance.

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Attendees noted that costs and potential negative impact associated with disclosing contracted prices could be greater than the penalties of non-compliance. In the end, leaders of provider organizations must weigh the potential backlash of non-compliance against meeting detailed requirements of the regulations. Ferris asked participants to share their insight on what the implications for non-compliance might be for the consumer.

A chief executive officer shared that he honestly could not assess how much, if any, of a consumer impact there might be due to current levels of skepticism about the utility of price transparency shopping tools. He noted recent research suggesting that, even if granted more information, people are not very good shoppers of healthcare services.

Participants noted that this reluctance from healthcare consumers might change over time and that healthcare organizations need to focus on educating and supporting consumer acceptance and usage of price transparency tools.

He suggested that the focus would be more about bipartisan issues as opposed to those demanding substantive partisan agreement.

Drug pricing was noted as one bipartisan issue that may see some change. Another area of the discussion centered on the permanency of policies that were temporarily reversed over the last year during the course of the pandemic. Policy extensions for things that probably should have been fixed long ago, telehealth for example which took a pandemic to shine a light on, would likely be made permanent.

Ferris noted how open enrollment for individual markets had been extended and that eligibility for and levels of subsidies provided to individual members using ACA marketplaces has been expanded over the last year. Ferris queried participants as to whether those policies might be made permanent and what impact might result from reverting back to previous subsidy determinations as compared to the current environment where a million new individuals have enrolled into the ACA Marketplace.

Open enrollment policies were raised by one attendee as conditional based on employment levels and likely influenced by state-level needs and policy determinations. While one participant noted the potential for more permanent changes to eligibility for subsidies and the level of subsidies, that participant also noted that subsidies related to COBRA coverage would likely not be made permanent because COBRA is directly impacted by the dynamics regarding unemployment and the need for coverage extension.

Given mid-year changes to open enrollment periods and subsidy levels, a high degree of uncertainty as to what health plan populations look like can exist — all while health plans are building packages for the next benefit year. A number of areas were identified as top of mind for both health systems and health plans and ripe for new regulations and development of formal policies:.

One participant noted that the entry of non-traditional market participants like Amazon are just the results of not addressing the cost of care through the ACA over the last decade. And certainly for Ferris asked panelists what they see as the role of technology in addressing policy changes and how technology will make an impact beyond the ACA — to consumers, providers, health plans, payers, and hospitals. That model is tough to scale and so clinicians are best focused on high clinical acuity and complex care.

And that includes leveraging remote patient monitoring capability, wearables, Etc. And so right now for a commercial line of business, you can do, for example, digital coaching and get reimbursed for it. So, I think, as it becomes more commonplace in the commercial market in evolution it will be more common in government programs.

I think technology is going to reinvent the shopping experience in healthcare for both obtaining health insurance as well as care delivery. But that's not the point. The point is that the government is involved in health care and it's going to continue to be involved in health care.

We can choose not to be interested in government and politics, but government and politics are interested in us. Withdrawing, or being angry or frustrated won't make them go away. Well I grew up as a hockey player and I can tell you that the only thing worse than skating to where the puck has been is to stand flat-footed and wait for the puck to come to you.

As business people, we can either passively accept the policy and regulatory climate that comes our way, or we can get involved and try to do something about it. At McKesson, we track thousands of pieces of legislation, and regulations affecting our business and our customers.

One of the remarkable things about health care is how often policy debates can devolve into a zero sum game pitting one part of the industry against the other. Payers vs.

When we allow these siloed debates to divide us, not only does it mean somebody wins, and somebody loses but we all lose. The people who end up winning are the cynics who don't want to see any progress at all. We have to rise above our narrow financial interests and work together to support each other and advocate for the policies that are good for the health care system as a whole, and good for patients.

We can argue that it's unfair that physicians are being overpaid for basic health care services that could easily be done by a pharmacist for less money, and more conveniently for patients. But to make the argument that way is going to end up with the doctors being pitted against the pharmacists.

Instead, we need to make the case that at a time when there is a significant shortage of primary care physicians, and dramatic expansion of coverage, we need to provide safe effective, convenient ways for patients to access care. Pharmacists are some of the most well trained, yet underutilized professionals in the health care system, and we should be leveraging their expertise to help patients become healthier.

We know there is an epidemic in this country of substance abuse, and it's easy to say it's the doctor's fault or it's the pharmacists fault, the wholesaler, the manufacturers or maybe even the government. But wouldn't it be more productive to get together and work on a solution instead of being pitted against one another.