Healthcare Program/Policy Evaluation Medicaid Program Evaluation

Healthcare Program/Policy Evaluation Medicaid Program Evaluation

Description Medicaid is a federal and state program aimed at improving the healthcare of the most vulnerable populations in low-income families and the aged population. The program finances the delivery of acute and primary healthcare services and also long term services and support (LTSS) to such populations. Participation in the Medicaid program is voluntary through all states, and each state is allowed to have their version of Medicaid, so long as it follows the broad federal rules. The program was established in 1965 and still runs to date. Unlike Medicare, the program offers other benefits such as nursing home and personal care services. The state and the federal government jointly finance the program. The Medicaid spending is, and entitlement and the total expenditure depend on the use of service by members that are enrolled and the state policy decisions. So long as states operate according to the federal requirements (in regards to program), they are entitled to matching funds from the Federal Medicaid fund. Therefore, Medicaid has become the largest source of health-related services to United States citizens with a low income, limited resources or elderly (65+ years)

How was the success

of the program or

policy measured? The success of Medicaid was measured using various data sources. The first metric of success was access and receipt of care for vulnerable individuals in the community that is covered by the program. If more people living below the poverty line and those aged 65 years and above had

better access to care, the program was successful. The success was also measured by the levels of enrollment and retention of eligible individuals within the program. Medicaid enrollment data from states was used to estimate the population increase and enrollment increase over the years. The program has had an increasing number since it was enacted, showing that it is successful. The program’s main aim is to reduce the healthcare cost on an individual while providing quality care. Addressing the beneficiary per month of spending on healthcare and comparing it to the spending of those without Medicaid also evaluates the program’s success. Success was also measured by identifying the number of providers that participated in the program. The larger the number of providers participating in Medicaid, the higher the success rate of the program.

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

The Center for Medicare and Medicaid Services (CMS) shows that as of 2019 over 75 million Americans were enrolled in the Medicaid program. Fifteen percent of those enrolled were the disabled population in the community. 40 percent were children and others were young adults and aging people that qualified to benefit from the program. Medicaid is the most successful program in reducing poverty of all other types of health insurance programs spearheaded by the government. The coverage from the program has increased economic mobility of vulnerable populations, thus impacting the educational levels, incomes, personal and community development. The program has also had an impact of reducing the infant, youth and adult mortality rates in vulnerable populations.

What data was used Program based data was used to conduct the evaluation. Information was obtained from each to conduct the program or policy evaluation? state and consolidated. Healthcare information systems were used as the primary source of the data. Statistical data on the number of individuals enrolled in the program was obtained through federal and state websites. Population-based data was used to evaluate the coverage and impact of the program on the intended population.

What specific

information on

unintended

consequences were

identified?

The program’s unintended consequences were identified in relation to Medicaid waivers the current government is trying to push through. The current government policy enables states to take away coverage from beneficiaries that do not meet the eligibility requirements, such as work requirements. Many people who are eligible and meet the work requirements are likely also to lose their coverage. The waiver on the program is not consistent with the program’s goals of providing affordable care to most vulnerable populations. Thus, Medicaid was not intended to serve all those that were poor but is limited to definite groups defined by other programs within the society. The program focuses on groups such as children, adults, and the elderly who are impoverished. It, however, forgets other eligible groups such as single or married adults without dependent children. The program thus reflects on the emphasis of social welfare but does not satisfy its scope of unmet healthcare needs of the American population.

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 The main stakeholders of the Medicaid program include the provider community, governor offices, Medicaid and agency leadership, CMS, the State legislature, and the patient and advocacy community. Medicaid and agency leadership would benefit the most from the reports of the program evaluation. The stakeholder would use the information on the report to assess the program’s impact and effect and identify any loopholes in the program and thus correct them. For example, from the report, the agency can identify the program’s effectiveness according to the data collected. If the program was not effective, the agency and Medicaid leadership could put strategies to increase program efficiency and direct the program towards attaining set objectives.

specific and provide examples.

Did the program or

policy meet the

original intent and

objectives? Why or

why not?

The Medicaid met the originally intended purpose of reducing healthcare costs to the most vulnerable populations in the community. The government chips into aid individuals meet the cost of the care they receive. The program has also increased access to care for such populations, as was it’s initial objective. The country has over 75 million people enrolled in the program, and the number is projected to increase.

Would you

recommend

implementing this

program or policy in

your place of work?

Why or why not?

I would recommend the implementation of the program in the workplace. Medicaid increases compensated care costs within the facility. Providers are assured that the state or government will fund various services to vulnerable populations, thus providing healthcare and living out of the same. The program increases the operating margins for medical facilities and facilitates the community’s health within which a facility thrives. The program supports many healthcare facilities, which would otherwise fail if the program was not implemented.

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of The first way to participate in program evaluation is through joining a nursing association such as the American Nurses Association (ANA). The association is often tasked with researching the effectiveness of a healthcare policy of the program. Nursing associations have advocacy tools accessible to members, and such could be used in evaluating healthcare programs and policies. As a member of the association, one can be part of such evaluations. Another way to be involved in the program evaluation process is through volunteering in local and state government healthcare programs as a nurse. Volunteering may be for a specific period and a nurse’s input implementation. could be useful in evaluating healthcare programs. Healthcare evaluations are done in conjunction with efforts from the local, state, or federal authorities. Assuming leadership roles by obtaining further education, in such authorities is also a way of getting involved in program evaluation.

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