Healthcare policy is an integral aspect of the U.S. healthcare system—one that helps shape and protect the health and well-being of our population. Policy impacts issues as fundamental as healthcare access, cost, delivery methods, and privacy. It involves the rules and regulations set forth by lawmakers on a local, state, and national level.
As a current or future nurse, you should know what healthcare policy is, how it works, and why it’s important—so that you can use your expertise to help shape new policies. Or if you’re a health administrator, your understanding and involvement in health policy will help you optimize current policies and guide teams to follow them. In this post, we’ve outlined what you need to know about healthcare policy, including how you can advance your career as a health advocate and policymaker.
What Is Healthcare Policy?
The term “healthcare policy” refers to the decisions, goals, and actions that determine how care is administered and accessed. ((Ballotpedia, “Healthcare Policy in the United States”: For example, policies can include legal and safety regulations by state or protocols regarding how care and medicine are delivered to patients at a specific hospital. “Healthcare policy” also refers to the policies set on a national level, in terms of access to healthcare, coverage, and cost.
Subcategories of health policy include public health, global health, healthcare services, health insurance, mental health, and pharmaceuticals.
Why Healthcare Policy Is Important
Healthcare policy is important because it helps establish guidelines that benefit patients, healthcare organizations, and our healthcare system. Having protocols in place can help prevent human error and poor communication around medical decisions.
For nurses and health administrators, understanding and following policies can help ensure that you deliver the best care to patients while using your knowledge to help inform future policies. On a broader level, when patients take the time to understand healthcare policy, they learn more about their rights.
Examples of Healthcare Policies
To be able to maintain quality care for patients, organizations must set policies to address the following aspects of their operations. ((PowerDMS, “Examples of Healthcare Policies,” Dec. 22, 2020.
Patient Care Policies
Patient care policies cover protocols and workflow for treatment procedures, outlining how healthcare professionals should respond to specific medical situations. Of course, policies must be tailored to the care your facility provides. For example, a cancer center would create different patient care policies than would a center for rehabilitative medicine, because their treatment protocols are so different.
Employee Health Policies
The health of employees is a crucial component of running an effective facility, as staff must be able to care for patients safely, while maintaining their own well-being.
Examples of policies designed to protect and promote employee health include rules around the consumption of alcohol and tobacco in the workplace, wearing masks and gloves to minimize the risk of exposure to illnesses and chemicals, and wellness policies such as time off and healthy eating.
Drug Policies
Drug policies outline procedures around the handling and administering of pharmaceuticals, whether the medication is over-the-counter, controlled, or non-controlled. This can include protocols for recording, handling, and delivering each medication. ((Kimberly New, “Drug Diversion Regulatory Requirements and Best Practices,” Patient Safety & Quality Healthcare, Nov. 18, 2020: Drug policies also cover what to do if inventory is missing, if medication was incorrectly administered or prescribed, or if any other errors occur related to drug handling.
Security and Privacy Policies
Security policies clearly outline how employees should handle situations that pose a security threat in their facility. This can include situations like abuse towards medical staff, patient abductions or elopements, theft, and active shooters. ((Lowers & Associates, “5 Current Threats to Hospital Security,” The Risk Management Blog, March 28, 2018: If a facility has security processes, these must be clearly outlined for all employees to know and follow.
Aside from physical security, data privacy and technology security policies and procedures are extremely important in any healthcare facility. The HIPAA Privacy Rule protects patient information from release to the public, while permitting the exchange of this information if needed between medical professionals and in certain other situations. Failure to comply with HIPAA can result in fines of $50,000 or higher per violation. ((Alex M. Azar II, “Annual Civil Monetary Penalties Inflation Adjustment,” U.S. Department of Health & Human Services, January 17, 2020.
The more that technology becomes an integral component in how healthcare facilities operate, the greater the chance that data leaks and privacy breaches can occur. In 2020, there were 600 healthcare breaches, a 55 percent increase from 2019. The average cost per breached record is now almost $500. ((Bitglass, “Healthcare Breach Report 2021: Hacking and IT Incidents on the Rise,” Feb. 17, 2021: This is why it’s crucial that facilities clearly specify policies and procedures regarding the handling of data to avoid errors that can result in privacy leaks.
Healthcare Policy Issues
For many families, healthcare takes up a huge portion of their budget. There is an ongoing debate over who has access to coverage and why the costs of care are so high in the United States, which is why some policymakers are trying to find solutions to improve access to affordable and quality care for all. Below, we explore a few major health policy issues impacting Americans today.
