HCAD 620 University of Maryland The US Healthcare System Policy Briefing

 Develop a policy analysis based on the scenario presented below.  

NOTE: Some of the facts in this scenario are hypothetical; others are actual. 

FACTS:

As a mid-career health analysis, you have recently been hired as the Health Policy Coordinator for the Alliance for Rural Health. The Executive Director of the Alliance has requested that you prepare a policy briefing discussing the delivery of Health Care Services to the residents of Appalachian Kentucky.

The Appalachian region of Kentucky is comprised of 54 counties with a total population of approximately 1.2 million. In Appalachian Kentucky, 100% of the population would be considered rural by Federal standards, as only 2.6% live in a town of 20,000 or more, the single incident of Richmond city. The average adult in Appalachian Kentucky reports feeling physically unhealthy 47% more often than the average American and 23% more often than the average adult in non-Appalachian Kentucky. The average adult in Appalachian Kentucky reports feeling mentally unhealthy 25% more often than the average American and 15% more often than the average adult in non-Appalachian Kentucky.

In addition, recent surveys of the behavioral health system, clinics, and tribal health center report significant rates of depression, post-traumatic stress disorder, schizophrenia and substance abuse / dependence among Appalachian Kentucky residents. There is concern that these problems are related to high rates of suicide and domestic violence.

Finally, other reports from social service agencies report that there is a significant population in the region that is effectively homeless, living seasonally (or sometimes year-round) in campers, tents, or out of automobiles, moving between campgrounds or camping areas in the state park grounds. This population includes families with children in some cases.

***Please ANSWER THESE- The paper should accomplish the following:

Discuss the problem of underserved populations and subgroups, including characteristics of those groups and barriers to delivery.

Examine the structure of the delivery system and how this helps or hinders health delivery.

Discuss the impact of ACA.

  1. Make clear recommendations as appropriate for meeting the health delivery challenges ofAppalachian Kentucky.
  2. PLEASE INCLUDE SOME CHARTS/GRAPHICS.
  3. Please prepare a well written, well organized, and professionally structured policy paper.
  4. **References (Please use these plus additional research ALL REFERENCES MUST BE 2018-2023)
  5. Stephen L. Wagner. (2021). The United States Healthcare System: Overview, Driving Forces, and Outlook for the Future. AUPHA/HAP Book.

Leigh Cellucci. (2019). Essentials of Healthcare Management: Cases, Concepts, and Skills, Second Edition: Vol. Second edition. Health Administration Press.  

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HCAD 620 University of Maryland The US Healthcare System Policy Briefing

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Introduction:
The purpose of this policy analysis is to address the delivery of healthcare services to the residents of Appalachian Kentucky, a region characterized by a predominantly rural population facing unique health challenges. This analysis will discuss the problem of underserved populations and subgroups, examine the structure of the healthcare delivery system, explore the impact of the Affordable Care Act (ACA), and provide recommendations for meeting the health delivery challenges specific to Appalachian Kentucky. The analysis will be supported by current research and scholarly references.

Answer 1:
Underserved populations and subgroups in Appalachian Kentucky face several characteristics and barriers to healthcare delivery. The region’s rural nature, with only 2.6% of the population living in a town of 20,000 or more, poses geographical and logistical challenges in accessing healthcare services. Limited availability of healthcare providers and facilities exacerbates the problem, leading to a lack of primary care options and specialized services.

Moreover, the average adult in Appalachian Kentucky reports feeling physically and mentally unhealthy at higher rates than their counterparts in non-Appalachian areas. This suggests a higher prevalence of health issues and disparities, which can further contribute to the underserved status of certain subgroups within the population. For instance, recent surveys have indicated significant rates of depression, post-traumatic stress disorder, schizophrenia, and substance abuse/dependence among Appalachian Kentucky residents. Additionally, high rates of suicide and domestic violence raise concerns about the overall well-being of the population.

Barriers to healthcare delivery in this context include limited healthcare infrastructure, insufficient healthcare resources, insufficient healthcare workforce, and inadequate health education and awareness programs. Lack of transportation options and poverty also contribute to reduced access to healthcare services, especially for those living in remote areas or with limited financial means.

Answer 2:
The structure of the healthcare delivery system in Appalachian Kentucky presents both advantages and hindrances to health delivery. On one hand, the system’s focus on primary care and community-based healthcare allows for a more personalized approach, which can be beneficial in addressing the specific needs of underserved populations. The emphasis on primary care can promote preventive healthcare measures and early intervention, leading to better health outcomes.

However, the limited availability of healthcare providers and facilities poses a significant hindrance to health delivery in the region. The shortage of healthcare professionals, particularly specialists, requires residents to travel long distances to receive specialized care. This geographical barrier not only creates inconvenience but also increases the likelihood of delayed or inadequate treatment. The lack of comprehensive healthcare infrastructure, including hospitals with advanced medical technologies, further hinders the delivery of timely and effective healthcare services.

Answer 3:
The Affordable Care Act (ACA) has had implications for healthcare delivery in Appalachian Kentucky. The expansion of Medicaid under the ACA has led to increased access to healthcare coverage for low-income individuals and families, potentially benefiting underserved populations. The availability of Medicaid and subsidized insurance plans has reduced financial barriers to healthcare services, thereby facilitating better access to care for many residents.

Moreover, the ACA’s emphasis on prevention and public health has the potential to improve population health outcomes in Appalachian Kentucky. By promoting preventive services, such as screenings and vaccinations, the ACA aims to address health issues before they become more severe and costly to treat. This preventive approach aligns with the region’s need for earlier interventions and chronic disease management.

However, challenges persist in fully realizing the impact of the ACA in Appalachian Kentucky. Limited awareness and understanding of the ACA and its benefits among the population may hinder enrollment and utilization of available healthcare services. Additionally, the financial sustainability of healthcare providers, particularly in rural areas, can be threatened by changes in reimbursement rates and the overall healthcare system’s transition towards value-based care.

Answer 4:
To effectively meet the health delivery challenges of Appalachian Kentucky, several recommendations can be made. Firstly, increasing the availability of healthcare providers, especially specialists in key areas of need such as behavioral health, is crucial. Incentivizing healthcare professionals to practice in rural areas, creating loan forgiveness programs, and expanding telemedicine services can help bridge the healthcare workforce gap.

Secondly, improving healthcare infrastructure is essential. This includes investing in the construction and expansion of hospitals, clinics, and healthcare facilities throughout the region. Additionally, enhancing transportation options, including public transportation and medical transportation services, can alleviate geographical barriers and improve access to healthcare for residents.

Thirdly, comprehensive and culturally sensitive health education programs should be implemented to raise awareness about preventive care, mental health services, and available healthcare resources. Engaging community leaders, local organizations, and schools can help disseminate relevant information and promote health-seeking behaviors.

Lastly, collaboration among healthcare providers, social service agencies, and community organizations is necessary to develop integrated care models that address the multifaceted needs of underserved populations. This can involve establishing partnerships, coordinating services, and leveraging resources to create a continuum of care that improves health outcomes and reduces healthcare disparities.

Conclusion:
Addressing the challenges in delivering healthcare services to the residents of Appalachian Kentucky requires a multi-faceted approach. By recognizing the characteristics and barriers faced by underserved populations, understanding the structure of the healthcare delivery system, and considering the impact of the ACA, policymakers and healthcare leaders can develop targeted strategies to improve access, quality, and outcomes in the region. Implementing the recommendations outlined above, along with ongoing evaluation and adaptation, can contribute to a more equitable and effective healthcare system for Appalachian Kentucky.

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