Health Policy stakeholdera

Stakeholder

Role

Consumer

Receiver of services/care

Provider

Organizations, facilities and individual practitioners who provide health services

Employer

Private and government employers who purchase health insurance and benefits coverage for their employees and dependents

Insurer

Companies licensed to do business as a health insurer or managed care company that arranges for and pays for services, in whole or part, to covered individuals

Government (as payer)

Provide health services coverage for certain categories of individuals ( beneficiaries ) such as Medicare, Medicaid and Children’s Health Insurance Programs

Government (as regulator)

Review facilities and individual practitioners to determine conformance with federal and state laws, and issue licenses; develops and implements rules and regulations to implement law; provides information to inform public

Accrediting Body

Organizations that review and accredit health facilities and health insurance plans, such as Joint Commission and NCQA

Professional Association/Special interest Group

Organizations that advocate for and represent the interests of its members, such as American Medical Association, American Association of Retired Persons

Pharmaceutical Company

Research, develop and distribute medications and prescription drugs

Medical supplier and medical equipment firm

Manufacture and distribute materials, supplies and medical equipment

Legislative Entity

State and federal legislative bodies, such as Congress and state Assemblies and legislatures, who pass laws