FINAL PAPER DUE Week 10 (today). Topic: Select Health Policy Analysis Paper on a local, state, or federal policy that you have explored along with recommendations based upon the analysis. • Analyze and evaluate the Health Policy • Identify application of health policy into clinical practice. ➢ Your paper must have an Introduction and a Conclusion ➢ Maximum of 6 pages (not including Title and Reference page). ➢ APA format ➢ At least 5 references within 5 years

Health Policy Analysis: The Impact of Medicaid Expansion on Access to Care

Introduction

Healthcare policy plays a crucial role in shaping the delivery of healthcare services and access to care. One particularly significant policy is the expansion of Medicaid, a public health insurance program designed to provide coverage for low-income individuals and families. The aim of this paper is to analyze and evaluate the impact of Medicaid expansion on access to care and its application into clinical practice.

Medicaid Expansion: An Overview

Medicaid expansion, authorized by the Patient Protection and Affordable Care Act (ACA) in 2010, allows states to extend Medicaid eligibility to individuals with incomes up to 138% of the federal poverty level. By expanding Medicaid, states can cover a larger portion of the uninsured population, enabling greater access to healthcare services. As of 2021, 38 states and the District of Columbia have opted to expand Medicaid, while 12 states have chosen not to expand.

The Impact on Access to Care

Numerous studies have examined the impact of Medicaid expansion on access to care, with consistent findings suggesting positive outcomes for the expansion population. For example, a study by Sommers, Gawande, and Baicker (2020) found that Medicaid expansion led to significant reductions in the uninsured rate and improved access to primary care services. Furthermore, expansion states reported increases in preventive care utilization, screenings, and chronic disease management.

Access to Specialty Care

While access to primary care has improved under Medicaid expansion, access to specialty care remains a challenge. Evidence suggests that expanded Medicaid coverage has not resulted in significant improvements in specialty care access, primarily due to factors such as provider shortages, limited networks, and reimbursement rates (Powers, Stevens, & Wilensky, 2017). As a result, individuals relying on Medicaid may experience delays in receiving specialty care, leading to potentially adverse health outcomes.

Integration into Clinical Practice

The application of health policy into clinical practice is essential for effectively translating policy goals into improved patient care. Healthcare providers play a critical role in ensuring the successful integration of Medicaid expansion into clinical practice, particularly through increased provision of preventive care and chronic disease management. According to Buchmueller, Garthwaite, and Miller (2018), providers in expansion states have reported an increase in Medicaid patients and have demonstrated increased provision of preventive services. This integration is crucial for maintaining the health of the expanded population and reducing health disparities among vulnerable populations.

Recommendations

While Medicaid expansion has shown positive effects on access to care, there are areas for improvement within the policy framework. The following recommendations aim to address existing challenges and further enhance the impact of Medicaid expansion on access to care:

1. Increase Provider Reimbursement Rates: Low Medicaid reimbursement rates remain a barrier to access, particularly in specialty care. Increasing reimbursement rates can incentivize more providers to accept Medicaid patients, therefore improving access to specialty care.

2. Expand and Support Provider Networks: Expand the number of providers within Medicaid networks to ensure an adequate supply of healthcare providers. Additionally, implement support programs to assist providers in navigating the administrative requirements of Medicaid, thereby improving engagement and participation in the program.

3. Strengthen care coordination: Enhance care coordination between primary care providers and specialists to streamline access and ensure timely referrals. Improved communication and information sharing can lead to better coordination of care, reducing delays in accessing specialty services.

4. Address Health Disparities: Target efforts towards reducing health disparities among underserved populations. Implement community-based interventions and outreach initiatives to increase awareness of Medicaid eligibility and services, particularly among minority and low-income populations.

Conclusion

Medicaid expansion has had a positive impact on access to care, improving the uninsured rate and increasing utilization of primary care services. However, challenges remain in ensuring access to specialty care and addressing health disparities. By addressing these challenges through increased reimbursement rates, expanded provider networks, strengthened care coordination, and targeted efforts towards reducing health disparities, the impact of Medicaid expansion on access to care can be further enhanced. The successful integration of Medicaid expansion into clinical practice relies on the active engagement and collaboration of healthcare providers in delivering high-quality care to the expanded population.