Assignment: NURS 5050 Assessing a Healthcare Program/Policy Evaluation
Solution
Healthcare Program/Policy Evaluation Analysis
| Healthcare Program/Policy Evaluation Analysis | Medicare healthcare program |
| Description | Medicare, instated in 1965 and currently managed by the Centers for Medicare and Medicaid Services (previously under the social security administration), serves as a nationwide health insurance initiative. Primarily catering to individuals aged 65 and above, it also extends coverage to younger individuals dealing with disabilities, end-stage renal disease, and amyotrophic lateral sclerosis (Medicare Payment Advisory Commission, & Book, 2012). Comprising four key components, the program addresses specific services: part A focuses on hospital insurance for inpatient care, part B covers medical insurance for doctor services and outpatient care, part C offers an alternative managed Medicare allowing patients to select health plans covered by either part A or B, and part D provides prescription drug coverage. |
| How was the success of the program or policy measured? | Evaluating the effectiveness of Medicare, a program focused on long-term healthcare, involves a thorough examination over time, with emphasis on quality assessment. One method employed is the use of episode-based quality measurement, which gauges the program’s attainment of specific objectives. This approach allows for the evaluation of physicians and care teams involved in patient care, particularly for individuals dealing with multiple chronic diseases. Episode-based quality measurements specifically take into account the various episodes of illness, especially in cases of chronic conditions. The program also incorporates other measurement types, including condition-based measures, procedure-based measures, primary prevention measures, and overall health status assessments. By employing these measures systematically, the success of the Medicare program can be comprehensively evaluated. |
| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected? | As per the 2019 Medicare trustee report, the Medicare program has extended health insurance coverage to approximately 59.9 million individuals. Of this total, around 52 million are individuals aged 65 and older, while about 8 million are younger individuals and those grappling with chronic illnesses. The noteworthy impact of the program is evident in government spending, which reached approximately $776.2 billion in 2020, marking a significant increase since its establishment in 1965. Currently, only about 2% of the elderly population lacks coverage under the Medicare insurance program, a remarkable improvement from the 48% who lacked medical insurance at the program’s inception. Notably, the availability of quality healthcare services and financial coverage provided by the program has contributed to a noteworthy 15% increase in the life expectancy of Americans aged 65 and above. |
| At what point in program implementation was the program or policy evaluation conducted? | The initial assessment of the Medicare program occurred in 1979, approximately 14 years after its establishment. At that time, enrollment was relatively modest, with around 521,894 beneficiaries. Recognizing the need for increased participation, the program underwent enhancements through the involvement of Health Maintenance Organizations and financial incentives. This approach resulted in the incorporation of additional health plans, thereby attracting a greater number of enrollees (King, et.al, 2011). However, it’s essential to note that the evaluation of the program is an ongoing process, marked by the provision of annual reports detailing its successes and advancements. This continuous evaluation is imperative due to the program’s nature as a long-term healthcare initiative. |
| What data was used to conduct the program or policy evaluation? | The yearly enrollment figures serve as a key metric for assessing the overall success of the Medicare program. In its early stages, only approximately 521,894 older individuals had enrolled. Contrasting this with the current enrollment figure of around 59.9 billion people represents a significant 48% increase, underscoring the program’s growth and effectiveness (King, et.al, 2011). However, the evaluation of the program’s success extends beyond enrollment numbers. It also involves comprehensive assessments of the quality of healthcare services delivered in facilities catering to Medicare enrollees. By considering both enrollment trends and the quality of health
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