With their unique, expert perspective, adult-gerontology acute care nurse practitioners (AG-ACNPs) must understand how policies affect patient health to deliver patient-centered, high-quality and cost-effective care. With a rapidly aging U.S. population, AG-ACNPs will likely care for more older adults with more complex health problems, activity limitations or disabilities, fixed incomes and lack of resources.
Exploring the intersection of policy and healthcare can empower nurses to provide more holistic care to improve patient health. A Master of Science in Nursing (MSN) – AGACNP online program equips graduates with the knowledge to bridge the gap between policy and healthcare and help them work together.
How Does Policy Impact Health?
Policy scope is vast — it involves laws, regulatory measures, action or inaction, and economic or funding priorities. Health is not just healthcare but the intersection of many factors, including social determinants of health (SDOHs), regulation of goods and services and natural resources, and public health mandates and support.
SDOHs refer to “conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” according to the U.S. Department of Health and Human Services Healthy People 2030 page.
The COVID-19 pandemic highlighted extreme healthcare disparities in access and outcomes. In an analysis of 71 performance measures across five domains — access to care, care process, administrative efficiency, equity and health care outcomes — the United States ranked last overall. Despite spending far more of its gross domestic product on healthcare, the U.S. requires significant improvements, including addressing healthcare inequalities.
For example, the Agency for Healthcare Research and Quality outlines six aims for the healthcare industry (care that is safe, timely, effective, efficient and equitable, and patient-centered).
How Can Policy Improve SDOHs?
SDOHs are a barrier to wellness and good patient outcomes. Basic needs such as safe housing and outdoor space, healthy food choices, transportation, community and social support are required for well-being. In addition, more studies suggest that SDOHs lead to more health inequity than race or ethnicity.
Public policy can provide direct support for SDOHs as drivers of health. For example, state and federal governments have assistance programs for various needs, including food insecurity. One example is the previously known Food Stamp Program, now SNAP (the Supplemental Nutrition Assistance Program), which provides monthly funds to buy food. Some may also qualify for the Special Supplemental Nutrition Program for Women, Infants and Children (known as WIC) nutrition program for pregnant, breastfeeding women and families with young children. Furthermore, public policy and community resources can provide temporary support and develop support solutions to help people increase self-sufficiency.
How Does Policy Relate to Economic Care Factors?
Policies can influence economic factors, including individual, employer or insurance responses:
- Individual Impact. Healthcare-related costs can exhaust financial resources, causing significant debt and even bankruptcy. Two-thirds of bankruptcy filings are due to a medical issue that requires time off work or the high cost of care. While the Affordable Care Act improves coverage and access to care, the proportion of filings for medical bankruptcy is not lowering.
- Employer Strategies. Employee absence means loss of productivity and cost. In support of healthy behaviors, some workplaces provide financial incentives. For example, some employers pay up to three hours per week for employees to exercise. Others encourage mental health breaks by allowing work time to play games or use a relaxation pod. Both strategies shorten the 40-hour work week as a health investment for a healthier workforce.
- Insurance Carrier Reponses. Conversely, instead of positive reinforcement of healthy behaviors, there can be penalties for poor health choices. For example, third-party payers can charge a “tobacco surcharge” of up to 50% more for people who use tobacco. Although legislators disagree on the best way forward, the debate shows how policy can impact the well-being of the general population.
The relationship between policy and health is bidirectional, meaning policy can impact health, and health can impact policy. Nursing care supports an integrated services approach between policy, public programs and clinical health care services. Since AG-ACNPs spend more time with patients to gather unique insight into their health and life needs, behaviors, habits, desires and wishes, they can personalize their approach.
The online MSN – AGACNP program at Northern Kentucky University (NKU) includes a Health Care Policy and Economics in Population Health course. This course introduces students to healthcare issues and policies influenced by technological, social, economic and political factors. It also examines healthcare availability and access and actions for dealing with healthcare dilemmas, federal and state regulatory programs and healthcare financing. Graduates will learn to help prevent, reform or navigate these policy-related issues.
Learn more about NKU’s online MSN – AGACNP program.
