Health Care Policy and Complementari and Alternative Care (Due 24 hours)

Essential V: Healthcare Policy, Finance, and Regulatory Environments

Rationale

Healthcare policies, including financial and regulatory policies, directly and indirectly influence nursing practice as well as the nature and functioning of the healthcare system. These policies shape responses to organizational, local, national, and global issues of equity, access, affordability, and social justice in health care. Healthcare policies also are central to any discussion about quality and safety in the practice environment. The baccalaureate educated graduate will have a solid understanding of the broader context of health care, including how patient care services are organized and financed, and how reimbursement is structured.

Regulatory agencies define boundaries of nursing practice, and graduates need to understand the scope and role of these agencies. Baccalaureate graduates also will understand how healthcare issues are identified, how healthcare policy is both developed and changed, and how that process can be influenced through the efforts of nurses, and other healthcare professionals, as well as lay and special advocacy groups.

Healthcare policy shapes the nature, quality, and safety of the practice environment and all professional nurses have the responsibility to participate in the political process and advocate for patients, families, communities, the nursing profession, and changes in the healthcare system as needed. Advocacy for vulnerable populations with the goal of promoting social justice is recognized as moral and ethical responsibilities of the nurse. The baccalaureate program prepares the graduate to:

1. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends.

2. Describe how health care is organized and financed, including the implications of

business principles, such as patient and system cost factors.

3. Compare the benefits and limitations of the major forms of reimbursement on the

delivery of health care services.

4. Examine legislative and regulatory processes relevant to the provision of health

care.

5. Describe state and national statutes, rules, and regulations that authorize and

define professional nursing practice.

6. Explore the impact of sociocultural, economic, legal, and political factors influencing healthcare delivery and practice.

7. Examine the roles and responsibilities of the regulatory agencies and their effect

on patient care quality, workplace safety, and the scope of nursing and other health

professionals’ practice.

8. Discuss the implications of healthcare policy on issues of access, equity,

affordability, and social justice in healthcare delivery.

9. Use an ethical framework to evaluate the impact of social policies on health care,

especially for vulnerable populations.

10. Articulate, through a nursing perspective, issues concerning healthcare delivery

to decision makers within healthcare organizations and other policy arenas.

11. Participate as a nursing professional in political processes and grassroots legislative efforts to influence healthcare policy.

12. Advocate for consumers and the nursing profession.

Sample Content

· policy development and the legislative process

· policy development and the regulatory process

· licensure and regulation of nursing practice

· social policy/public policy

· policy analysis and evaluation

· healthcare financing and reimbursement

· economics of health care

· consumerism and advocacy

· political activism and professional organizations

· disparities in the healthcare system

· impact of social trends such as genetics and genomics, childhood obesity, and

aging on health policy

· role of nurse as patient advocate

· ethical and legal issues

· professional organizations’ role in healthcare policy, finance and regulatory

environments

· scope of practice and policy perspectives of other health professionals

· negligence, malpractice, and risk management

· Nurse Practice Act

Reference

American Association of Colleges of Nursing. (2017). The essentials of master’s education in nursing. March 21, 2011.