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NHS FPX 6008 Assessment 2 Needs Analysis for Change

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    NHS FPX 6008 Assessment 2 Needs Analysis for Change

    Student Name

    Capella University

    NHS-FPX 6008 Economics and Decision Making in Health Care

    Prof. Name

    Date

    Change Needs Assessment in Healthcare

    Healthcare, a fundamental human need, is facing a critical economic challenge in the United States due to the escalating costs and insufficient insurance coverage (Galvani et al., 2020). The inadequacy of health insurance means that a substantial portion of the population is unable to access essential healthcare services, leading to adverse health outcomes and placing a burden on the healthcare system (Institute of Medicine, 2019). This needs analysis will delve into the economic healthcare challenge posed by insufficient health insurance coverage and its repercussions on both the healthcare system and patients.

    The United States boasts one of the highest healthcare expenditures globally, accounting for over 17% of the country’s gross domestic product (GDP) (Yang, 2022). Despite this significant spending, a considerable number of Americans lack sufficient health insurance coverage, resulting in a major economic healthcare predicament. The absence of insurance coverage often leads to delayed or foregone medical treatments, negatively impacting individuals’ health (Gonzalez et al., 2021).

    The economic challenge of inadequate health insurance coverage affects individuals across all socioeconomic strata but has a more pronounced effect on low-income individuals and families. Despite the passage of the Affordable Care Act (ACA) in 2010 to enhance access to health insurance, millions of Americans continue to be uninsured or underinsured (ACA, 2019).

    Synopsis of the Economic Challenges of Inadequate Health Insurance

    The economic issue of inadequate health insurance coverage poses a significant obstacle, limiting access to essential healthcare services and adversely affecting individuals’ health and well-being (Keisler-Starkey & Bunch, 2021). This issue has extensive ramifications for my work, organization, colleagues, and community, hindering individuals’ ability to receive necessary healthcare services, resulting in poorer health outcomes, increased healthcare costs, and diminished productivity.

    Inadequate health insurance coverage can have a substantial impact on organizations, leading to increased healthcare costs, reduced employee productivity, and absenteeism. Employees facing challenges in accessing essential healthcare services due to insufficient insurance coverage are more likely to fall ill and require more extensive medical attention, resulting in higher healthcare costs for the organization (Folger, 2021).

    Inadequate health insurance coverage can also lead to decreased employee productivity and heightened absenteeism. Employees may postpone seeking necessary medical treatment or forgo preventive care due to financial constraints, leading to more severe health conditions, prolonged recovery times, and increased absenteeism, thereby affecting the organization’s overall productivity and profitability (Folger, 2021).

    The rationale for addressing this issue is evident. Ensuring universal access to affordable healthcare not only promotes individual and community health and well-being but also improves healthcare outcomes and reduces overall healthcare costs (Chernew et al., 2021). However, a significant gap persists between the availability of healthcare coverage and the needs of individuals who lack access due to this issue.

    Recent data from the United States Census Bureau reveals that over 28 million people in the United States lacked health insurance in 2020, representing a 0.8% increase from 2019. This gap may be attributed to challenging eligibility criteria and limited insurance options (Keisler-Starkey & Bunch, 2021). This coverage gap disproportionately affects low-income individuals and communities of color, contributing to healthcare disparities and exacerbating existing inequalities.

    Addressing the challenge of inadequate health insurance coverage necessitates a comprehensive approach, including expanding access to healthcare coverage, addressing systemic barriers to healthcare access, and advocating for policies prioritizing community health and well-being (Keisler-Starkey & Bunch, 2021).

    Socioeconomic and Diversity Disparities

    Significant socioeconomic and diversity disparities exist in how inadequate health insurance coverage affects access to healthcare services. Low-income individuals and communities of color bear a disproportionate burden, facing greater obstacles in accessing healthcare services and experiencing poorer health outcomes (Ndugga & Artiga, 2021).

    A study in the American Journal of Public Health indicates that individuals with lower incomes are more likely to lack health insurance coverage, with uninsured rates ranging from 25% to 40% for those below 200% of the federal poverty level (Cable, 2020). Additionally, racial and ethnic minority groups are more likely to lack health insurance coverage, with uninsured rates of 19% for Hispanics, 11% for Black individuals, and 8% for non-Hispanic White individuals (Artiga et al., 2021).

    These disparities in health insurance coverage have profound implications for access to healthcare services, with uninsured individuals less likely to receive preventive care, chronic disease management, and necessary medical treatment (Daghlas et al., 2021). This lack of access contributes to poorer health outcomes and higher healthcare costs, especially for individuals with chronic health conditions.

    Addressing these socioeconomic and diversity disparities in access to healthcare services requires targeted policies and interventions that prioritize the health and well-being of low-income individuals and communities of color. This may involve expanding Medicaid coverage, increasing access to affordable health insurance options, and addressing systemic barriers to healthcare access, such as transportation, language, and cultural barriers.

    Evidence-Based Sources

    Evidence-based sources emphasize the crucial nature of addressing inadequate health insurance coverage to improve access to healthcare services and promote individual and community health and well-being. Several sources highlight the need for potential change or implementation plans:

    A study in the Journal of Health Economics reveals that expanding Medicaid coverage is associated with significant increases in healthcare utilization and access to care, particularly for low-income individuals and those with chronic health conditions (Carpenter & Sansone, 2021). Research in Health Affairs suggests that implementing policies to increase access to affordable health insurance options can improve health outcomes and reduce healthcare costs (Young et al., 2021). A report from the Kaiser Family Foundation underscores significant disparities in health insurance coverage across racial and ethnic groups, emphasizing the need to prioritize policies addressing these disparities (Artiga et al., 2021).

    An article in the Journal of General Internal Medicine argues that addressing the issue of inadequate health insurance coverage requires a comprehensive approach, including expanding access to healthcare coverage, promoting policies prioritizing community health, and addressing systemic barriers to healthcare access (Shrank et al., 2021). Potential implementation plans to address inadequate health insurance coverage may include expanding Medicaid coverage, increasing access to affordable health insurance options, implementing policies prioritizing community health, and addressing systemic barriers to healthcare access. These plans may also involve increasing healthcare staffing to ensure adequate patient care.

    Implementation Plans to Address Inadequate Health Insurance

    The proposed change (enhanced access to health insurance) or implementation plan to address inadequate health insurance coverage can lead to several predicted outcomes and opportunities for growth, particularly in economic considerations. The predicted outcomes for the implementation plans include better access to healthcare services and improved health outcomes in the community. Moreover, another expected outcome is a better experience for healthcare providers and the organization. The opportunities for growth and predicted outcomes may include:

    Improved health outcomes: Increased access to healthcare services can lead to improved health outcomes, thereby reducing the economic burden of preventable illnesses and chronic conditions. Expanding Medicaid coverage has been shown to significantly reduce mortality rates, particularly for low-income individuals (Barbot, 2020).

    Increased productivity: Improved health outcomes can also contribute to increased productivity in the workforce, as healthier individuals are more likely to be able to work and perform their duties effectively. Workplace wellness programs prioritizing employee health can significantly improve productivity and job satisfaction (Lyons et al., 2022).

    Reduced healthcare costs: By improving access to healthcare services, individuals with inadequate health insurance coverage are less likely to rely on emergency department visits or other costly forms of care. A report from the Commonwealth Fund found that expanding Medicaid coverage can significantly reduce healthcare costs, particularly for low-income individuals (Ward, 2020).

    Increased economic growth: Improved health outcomes, increased productivity, and reduced healthcare costs can contribute to increased economic growth and stability. A report by Raghupathi and Raghupathi (2020) found that expanding access to healthcare coverage can positively impact economic growth, particularly in terms of job creation and increased spending on healthcare services.

    Conclusion

    A systematic evaluation of the economic healthcare issue of inadequate health insurance coverage at the primary care clinic has identified several potential solutions to improve access to care for uninsured patients. By implementing these solutions, the clinic can better serve its patient population and promote better health outcomes for the community.

    References

    Artiga, S., Hill, L., Orgera, K., & Damico, A. (2021, July 16). Health coverage by race and ethnicity, 2010-2019. Kff.org. https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-by-race-and-ethnicity/

    Barbot, O. (2020). George Floyd and our collective moral injury. American Journal of Public Health, 110(9), e1–e1. https://doi.org/10.2105/ajph.2020.305850

    Cable, N. (2020). COVID-19 pandemic: Urgent needs to support and monitor long-term effects of mental strain on people. American Journal of Public Health, 110(11), 1595–1596. https://doi.org/10.2105/ajph.2020.305938

    Carpenter, C. S., & Sansone, D. (2021). Cigarette taxes and smoking among sexual minority adults. Journal of Health Economics, 79, 102492. https://doi.org/10.1016/j.jhealeco.2021.102492

    Chernew, M., Cutler, D., & Shah, S. (2021, August 18). Reducing health care spending: What tools can states leverage? | Commonwealth Fund. Www.commonwealthfund.org. https://www.commonwealthfund.org/publications/fund-reports/2021/aug/reducing-health-care-spending-what-tools-can-states-leverag e

    Daghlas, I., Lane, J. M., Saxena, R., & Vetter, C. (2021). Genetically proxied diurnal preference, sleep timing, and risk of major depressive disorder. JAMA Psychiatry, 78(8), 903-910. https://doi.org/10.1001/jamapsychiatry.2021.0959

    NHS FPX 6008 Assessment 2 Needs Analysis for Change

    Folger, J. (2021, May 26). The causes and costs of absenteeism. Investopedia. https://www.investopedia.com/articles/personal-finance/070513/causes-and-costs-absenteeism.asp

    Galvani, A. P., Parpia, A. S., Foster, E. M., Singer, B. H., & Fitzpatrick, M. C. (2020). Improving the prognosis of health care in the USA. The Lancet, 395(10223), 524–533. https://doi.org/10.1016/s0140-6736(19)33019-3

    Gonzalez, D., Karpman, M., Kenney, G., & Zuckerman, S. (2021). Delayed and forgone health care for nonelderly adults during the COVID-19 pandemic. Urban.org. https://www.urban.org/sites/default/files/publication/103651/delayed-and-forgone-health-care-for-nonelderly-adults-during-the-covid-19-pandemic_1.pdf

    Institute of Medicine. (2019). Effects of health insurance on health. In G. Anderson, J. A. Barondess, A. Bindman, et al. (Eds.), Care without coverage: Too little, too late. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK220636/

    Keisler-Starkey, K., & Bunch, L. (2021, September 14). Health insurance coverage in the United States: 2020. The United States Census Bureau. https://www.census.gov/library/publications/2021/demo/p60-274.html

    Lyons, M. J., Fernandez Poole, S., Brownson, R. C., & Lyn, R. (2022). Place is power: Investing in communities as a systemic leverage point to reduce breast cancer disparities by race. International Journal of Environmental Research and Public Health, 19(2), 632. https://doi.org/10.3390/ijerph19020632

    Ndugga, N., & Artiga, S. (2021, May 11). Disparities in health and health care: 5 key questions and answers. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/

    NHS FPX 6008 Assessment 2 Needs Analysis for Change

    Raghupathi, V., & Raghupathi, W. (2020). Healthcare expenditure and economic performance: Insights from the United States data. Frontiers in Public Health, 8(156). https://doi.org/10.3389/fpubh.2020.00156

    Shrank, W. H., DeParle, N.-A., Gottlieb, S., Jain, S. H., Orszag, P., Powers, B. W., & Wilensky, G. R. (2021). Health costs and financing: Challenges and strategies for a new administration. Health Affairs, 40(2), 235–242. https://doi.org/10.1377/hlthaff.2020.01560

    Ward, B. (2020, May 5). The impact of Medicaid expansion on states’ budgets | Commonwealth fund. Commonwealthfund.org. https://www.commonwealthfund.org/publications/issue-briefs/2020/may/impact-medicaid-expansion-states-budgets

    Yang, J. (2022, January 4). U.S. health expenditure as GDP share 1960-2019 | Statista. Statista. https://www.statista.com/statistics/184968/us-health-expenditure-as-percent-of-gdp-since-1960/

    Young, G. J., Zepeda, E. D., Flaherty, S., & Thai, N. (2021). Hospital employment of physicians in Massachusetts is associated with inappropriate diagnostic imaging. Health Affairs, 40(5), 710–718. https://doi.org/10.1377/hlthaff.2020.01183