Policy Analysis and Development Discussion and Responses (Group 14, 16, and 18)


Group 14 Policy Analysis and Hospital Comparison Go to Hospital compare and select your Hospital and one other; what health policy would you attempt to change to deal with a striking local difference in treatment or outcome? Respond to group 14 post Group 16 Policy Analysis and Social Media How can we help enhance the […]

Group 14 Policy Analysis Prompt and Response

Hospital Comparison Essay

Hospital Compare is a website that allows consumers to compare hospitals and quality of care performance measures, such as readmission and death rates, to provide consumers with information about the quality of care administered to patients in selected hospitals (U.S. Centers for Medicare and Medicaid Services [CMS], 2016a). Additionally, the data provided on Hospital Compare is collected by the Centers for Medicare and Medicaid Services (CMS) under the Hospital Inpatient Quality Reporting Program (Hospital IQRP), which was originally mandated by Section 501(b) of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. The Hospital IQRP and Hospital Compare are intended to encourage hospitals and clinicians to improve the cost and quality of inpatient care by adjusting hospital payments based on their performance (CMS, 2016b). For example, Houston Methodist Hospital in the Texas Medical Center has a five-star overall rating for low incidences of surgical complications, infections, and deaths, either no different or better than the national average; whereas HCA Houston Healthcare Conroe has a one-star overall rating for surgical complications, infections, and deaths no different than the national average (CMS, 2016d; CMS, 2016c). Due to their quality performance rates, Medicare will consequently reimburse Houston Methodist Hospital more than HCA Houston Healthcare Conroe for the same services.

The Hospital IQRP is one of four quality programs under Medicare that has aided in improving the quality of hospital care over the years; however, improvements are still needed. One issue with the Hospital IQRP is that it includes costly process measures for hospitals to collect, difficult to report, and is often unrelated to patient outcomes (MedPAC, 2019). Additionally, the program does not consider patient populations seen in various hospitals and scores but only certain condition-specific outcomes – such as acute myocardial infarctions and readmissions – rather than focusing on all readmissions. MedPAC (2019) suggests completely eliminating the IQRP and merging the three quality payment programs into the Hospital Value Incentive Program (HVIP). The HVIP discussed by MedPAC (2019) would score all hospitals on set performance targets, including small population-based outcomes, and treat hospitals more equitably by accounting for differences in patients’ social risk factors.

Group 14 Response

Group 14 has presented a thorough analysis, which reveals that The Hospital Value Incentive Program (IQRP) should be changed to tackle the striking local differences in outcome or treatment. The team has taken an interesting approach to illustrate that the design of the existing hospital quality payment schemes, including IQRP, is complex. For instance, the program sends different performance signals to healthcare facilities and is sometimes duplicative. Additionally, the scheme in question scores only specific condition-specific measures, such as acute myocardial infarction readmissions, while disregarding the performance of those suffering from other ailments (The Hospital Value Incentive Program, 2019). All in all, the group is correct that IQRP consists of practice measures that are burdensome to report and are not linked to outcomes.

Group 14 has brought up interesting points asserting that an essential step in dealing with the striking local difference in outcome or treatment is to abolish IQRP. Subsequently, the remaining three quality payment elements should be simplified and combined into one referred to as the Hospital Value Incentive Program (HVIP). Implementing HVIP would reasonably account for dissimilarities in clinicians’ patient populations and catalyze significant development across the delivery system (Burda, 2019). I think the team is correct that the change would make the payment adjustment of Medicare unbiased among healthcare facilities that treat different patient inhabitants with diverse risk dynamics. Thus, I agree with the team that the new system would enhance equity and efficiency, as well as better outcomes for patients at less cost.

Group 16 Policy Analysis and Social Media Prompt and Response

Social Media Prompt

Group 16, I agree that social media can be useful for dispersing information and influencing legislation. The key point is that it is valuable if used intelligently to facilitate further discussion and advocate for change. As mentioned, people can get side-tracked more often than not and end up arguing about things completely irrelevant to the original issue. In some cases, the spread of fake news can be a potential threat to public health. A study was conducted on the spread of medical fake news on social media, and it was found that 40 percent of the most shared links for health information were fake news (Waszak, Kasprzycka-Waszak, & Kubanek, 2018). Fake medical news, such as vaccine conspiracies, can cause harm to society and derail social media posts advocating for policy change. Therefore, it is important to be able to distinguish fact from fiction.

Another way to get the most out of social media advocacy is to use hashtags indicating topics or themes for policy issues that “allows movements to spread organically to like-minded individuals and organizations and to spread virally to other users of the social media platform” (Saxton, Niyirora, Guo, & Waters, 2015, para. 3). Saxton et al. (2015) states that the participatory nature of hashtags makes them a powerful tool since they are not pre-determined but rather created by the user as a way to organize and search for information. Lastly, to generate awareness of policy issues, social media users must have an adequate number of followers who can further encourage advocacy by re-posting or re-tweeting messages.


Saxton, G. D., Niyirora, J. N., Guo, C., & Waters, R. D. (2015). #Advocatingforchange: The strategic use of hashtags in social media advocacy. Advances in Social Work, 16(1), 154–169. DOI: 10.18060/17952

Social Media Response

Group 16 has produced significant results demonstrating that the so-called “fake news” is a progressively documented element impacting information sharing on social media. Importantly, credibility is an essential assessment to consider as it shapes how individuals react to messages (Sommariva, Vamos, Mantzarlis, Đào, & Tyson, 2018). In this regard, the wider diffusion of messages linked to health is not fundamentally positive if the accuracy and quality of information are poor. The analysis provided by group 16 helps in understanding that misinformation beliefs are predominantly troublesome in the health domain, given that they can limit preventative behaviors and effective treatment options. I feel that the team is trying to imply that under the right circumstances, false news may not only be spread easily online but may as well be corrected on the platform.

There are various ways to enhance the advocacy messages posted on social media. One technique is to counter misrepresentation by promptly divulging users’ accurate information since this will generate a social amendment. The second approach uses data to flag misleading stories and decreases their visibility by adjusting algorithms. Finally, it is possible to utilize the strategies recently introduced by Facebook, which entails reducing the visibility of fabricated information by building on the work of experts and fact-checkers. Conversely, determining the authenticity of messages posted on social media requires public health authorities to encourage users to refute misleading and false information with evidence (Bode & Vraga, 2017). In brief, they must present users with correct sources to accompany their refutation.

Group 18: Effect of Nurses  on Policy

Nurses’ Effect on revisions of basic statutes

Nurses influence healthcare through their professional advancements while playing a key role in the evolution of our healthcare system. Nurses are often at the forefront of quality patient care and critical life-saving situations, and advocate for equal patient rights. It’s imperative that nurses understand the link between shaping healthcare and preeminent patient care. Nurses can help create policies, reform ineffective policies, and ensure policies are enforced. The Texas Nurse’s Association promotes empowerment through a conversation series informing nurses of pertinent policy issues as guiding the nursing population in decision-making processes.

Most educational nursing degree programs educate nurses on public policies, healthcare reform, and the empowerment of nursing leadership. Nurses across the country partner with hospitals or government services to create community/state initiatives to allow communities to provide quality healthcare to everyone. “At the highest levels, ANA advocates for policymakers to recognize the true value of nursing, and the unique perspective that nurses have to offer. The voices of nurses are instrumental in advancing public health.” (American Nurses Association, 2020)

The provisions of bill §215.1 were adopted to be effective January 2005, cataloging facility accountability for nursing education and standards and rules for reasonable nursing programs. The policy was amended several times, the last being effective August 9, 2018 (43 TexReg 5074). These amendments specified evaluation instruments, implementation policies, student achievements, educational facilities, and overall objectives of the original bill. “There shall be a written plan for the systematic evaluation of the effectiveness of the total program. The plan shall include evaluative criteria, methodology, frequency of evaluation, assignment of responsibility, and indicators (benchmarks) of the program and instructional effectiveness.” (TBON, 2020)

The provisions of §219.9, effective September 13, 2001, regulate the educational standards for the advanced practice of registered nurses required by the Texas Board of Nursing. This policy was amended on January 8, 2008, to apply minimum standards and expectations for educational intuitions the Texas Board of Nursing set forth. (26 TexReg 6889) (TBON, 2020)

Nurses Effect Response

By assessing Bill 215.1 as a revision for the RN license and Bill 219.9 as a revision for the APRN license, group 18 has demonstrated how nurses influence reviews of underlying statutes linked to their practice. I agree with the team that nurses’ experiences in their practice inspire them to take on some advocacy role to influence a transformation in regulations, laws, or policies that control the broader healthcare system. Nurses often face challenges linked to health disparities, patient satisfaction and safety, clinical outcomes, and access to service (Williams, Phillips, & Koyama, 2018). By taking on the role of a policy advocate, the providers in question often have to move into a less familiar arena where the regulations and laws influencing patient care are developed. In this area, they have to help in deciding to negotiate the utilization of scarce resources (Ellenbecker et al., 2017). The team’s response helps them understand that, as time-consuming and challenging as it may be, accepting the liability of being an advocate presents the nurses with a unique opportunity to bring a better healthcare system. Hence, the role adds a portion to their specialized practice that presents the reward of having more control over health outcomes and patient care.


Bode, L., & Vraga, E. K. (2017). See something, say something: Correction of global health misinformation on social media. Health Communication, 33(9), 1131–1140. DOI: 10.1080/10410236.2017.1331312

Burda, D. (2019, July 1). Why healthcare is spinning its VBR wheels. Retrieved from https://www.4sighthealth.com/why-healthcare-is-spinning-its-vbr-wheels/

Ellenbecker, C. H., Fawcett, J., Jones, E. J., Mahoney, D., Rowlands, B., & Waddell, A. (2017). A Staged Approach to Educating Nurses in Health Policy. Policy, Politics, & Nursing Practice, 18(1), 44–56. DOI: 10.1177/1527154417709254

Sommariva, S., Vamos, C., Mantzarlis, A., Đào, L. U.-L., & Tyson, D. M. (2018). Spreading the (Fake) news: Exploring health messages on social media and the implications for health professionals using a case study. American Journal of Health Education, 49(4), 246–255. DOI: 10.1080/19325037.2018.1473178

The Hospital Value Incentive Program: Measuring and rewarding meaningful hospital quality. (2019, January 30).

Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse Advocacy: Adopting health in all policies approach. OJIN: The Online Journal of Issues in Nursing, 23(3).


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