Discussion 1: Topic 2 Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States (may be state or federal).

Topic 7 DQ 1
Assessment Description
Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States (may be state or federal). What impact do these population health policies and initiatives have on advanced nursing practice?

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Healthcare Policy Issues
Access to healthcare coverage and healthcare cost and spending are two major policy issues that significantly affect the current healthcare delivery and population health equity in the United States. The push for healthcare coverage has led to notable reforms in the United States. Advocacy, policymaking, and legislative processes led to the adoption of the Patient Protection and Affordable Care Act to increase the health coverage of the population. This has seen a marked expansion in the number of insured individuals through private health insurance such as employer-sponsored and individually purchased insurance, and public insurance such as Medicare, Medicaid, and military coverage (Wray et al., 2021). The expanded coverage has been associated with improved access to quality care and improved patient outcomes tailored to reduced morbidity and mortality (Wray et al., 2021). To further improve the insurance status for all individuals, additional measures such as the amendment of the eligibility criteria of public insurance to more inclusive approaches may be required.
High healthcare cost and spending is other pertinent policy issue. Despite the increased insurance coverage through the aforementioned policies, high healthcare costs through the out-of-pocket payment of services not covered by health insurance are still a concern for many patients. The Affordable Care Act initiatives address this issue by fostering the cost-effective delivery of quality care (Warsame et al., 2020). This is achieved through targeted strategies such as patient involvement in decision-making regarding diagnostic and therapeutic interventions, patient-centered cost-saving strategies, utilization of cost-decision support tools, and engagement of healthcare professionals in cost-consciousness (Warsame et al., 2020). More subsidies on public health insurance may be needed to further cushion healthcare costs to prevent catastrophic spending by vulnerable individuals.
Population health policies and initiatives to address healthcare coverage and healthcare costs have implications on advanced nursing practice. The implementation of tailored programs has necessitated the development of advocacy and leadership competence by nurse practitioners to provide quality patient care while optimizing hospital reimbursement (Isola et al., 2022). The initiatives have also fostered coordination of care and collaboration of nurses with other healthcare providers in the adaptation of novel healthcare delivery systems. Nurses are also tasked with identifying gaps in the implemented policies and devising appropriate solutions that lead to policy improvement.

References
Isola, S., & Reddivari, A. K. R. (2022). Affordable Care Act. In StatPearls. StatPearls Publishing.
Warsame, R., Riordan, L., Jenkins, S., Lackore, K., Pacyna, J., Antiel, R., Beebe, T., Liebow, M., Thorsteinsdottir, B., Grover, M., Wynia, M., Goold, S. D., DeCamp, M., Danis, M., & Tilburt, J. (2020). Responsibilities, strategies, and practice factors in clinical cost conversations: A US physician survey. Journal of General Internal Medicine, 35(7), 1971–1978. https://doi.org/10.1007/s11606-020-05807-0
Wray, C. M., Khare, M., & Keyhani, S. (2021). Access to care, cost of care, and satisfaction with care among adults with private and public health insurance in the US. JAMA Network Open, 4(6). https://doi.org/10.1001/jamanetworkopen.2021.10275