NHS6008_Banta_Lucresha_Assessment 4-1
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Date
Dec 6, 2023
Type
docx
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Uploaded by ChancellorCapybara3440
Lobbying for Change
Lucresha Banta, RN, BSN
Economic Decision Making in Health Care
September 2023
The Honorable Senator Tommy Tuberville
B40A Dirksen Senate Office Building
Washington, DC 20510
Dear Senator Tuberville:
I am writing you today to address a concern within our healthcare system. Many
patients do not have adequate access to healthcare resources. They are either
uninsured or do not have access to early chronic disease management or prevention.
The current healthcare spending on chronic disease management is $4.1 trillion. It is
estimated that by 2040, 80.8 million people will be over the age of 65 (
www.cdc.gov
),
further putting a burden on healthcare spending. According to USnews.com, Alabama is
ranked 44
th
in the country for overall health, with 3,407/100,000 preventable hospital
admissions.
As insurance companies move to a value-based payment model, the shift
in care is transitioning to a wellness focus versus an illness or treatment focus. Chronic
diseases such as hypertension, diabetes, cancer, and neurological diseases are the
leading cause of death and disability in the US (Stoutenberg et al., 2023). These four
diseases account for approximately 160 million cases and $1.033 trillion in healthcare
spending (
www.cdc.gov
).
One way to help increase equitable healthcare among all patient populations is to
enlist community health workers. These workers are trained to assist patients with
health education, connect with community resources based on social determinants of
health, and connect with their primary care providers to ensure they receive appropriate
healthcare at the right time. In a study performed in Detroit with community health
workers, these workers saved Michigan Medicaid over $1.4 million over one year. The
study showed a decrease in the number of acute hospitalizations, a decrease in hospital
acuity, and an increase in the number of visits to primary care physicians (Heisler et al.,
2022).
Community health workers are specifically trained to assist patients with
diagnostic, treatment, and clinical services, assist with appropriate utilization of health
services and make referrals, provide health education, collect and record data, improve
relationships between health services and communities, and provide psychosocial
support (Scott et al., 2018).
Studies show that when community health workers are utilized, there is a 53%
reduction in hospital admissions and a 38% reduction in emergency room visits (Mistry
et al., 2021). These numbers are increasingly important as insurance companies
transition to value-based payment models. On a federal level, policies must be
developed to ensure that community health workers are integrated into the system.
Public policies need to be enacted that address community health workers to include
employment, strategies for implementation of community health workers, governing,
legal framework, and financing for these employees.
As a nurse who has spent 12 years in home health care, I saw firsthand how
important education was to patients coming out of the hospital with disease
exacerbations. Our goal was to prevent further hospitalizations of these patients. Now
that I work for a major insurance company working towards a universal value-based
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payment model, this education is even more essential. Attempting to educate patients
before they are sick or need emergency services. Insurance companies must utilize the
workers and begin education when patients sign up for insurance coverage. This will
help to decrease costs associated with chronic disease treatment, shifting the overall
focus to prevention.
Sincerely,
Lucresha Banta, RN, BSN
123 Main St
Gulf Shores, AL 36542
251-979-9876
References
Alabama Rankings | US News Best States
Health and Economic Benefits of High Blood Pressure Interventions | Power of
Prevention (cdc.gov)
Heisler, Michele,M.D., M.P.A., Lapidos, A., PhD., Kieffer, Edith,M.P.H., PhD.,
Henderson, J., PhD., Guzman, R., B.A., Cunmulaj, J., B.A., Wolfe, J., M.P.P.,
Meyer, T., EdM., & Ayanian, John Z,M.D., M.P.P. (2022). Impact on Health Care
Utilization and Costs of a Medicaid Community Health Worker Program in Detroit,
2018–2020: A Randomized Program Evaluation.
American Journal of Public
Health,
112
(5), 766-775. https://doi.org/10.2105/AJPH.2021.306700
Mistry, S. K., Harris, E., & Harris, M. (2021). Community Health Workers as Healthcare
Navigators in Primary Care Chronic Disease Management: a Systematic
Review.
Journal of General Internal Medicine,
36
(9), 2755-2771.
https://doi.org/10.1007/s11606-021-06667-y
Community Health Workers: Their Important Role in Public Health (nihcm.org)
Promoting Health for Older Adults | CDC
Scott, K., Beckham, S. W., Gross, M., Pariyo, G., Rao, K. D., Cometto, G., & Perry, H.
B. (2018). What do we know about community-based health worker programs? A
systematic review of existing reviews on community health workers.
Human
Resources for Health,
16
https://doi.org/10.1186/s12960-018-0304-x
Stoutenberg, M., Lewis, L. K., Jones, R. M., Portacio, F., Vidot, D. C., & Kornfeld, J.
(2023). Assessing the current and desired levels of training and applied
experiences in chronic disease prevention of students during medical
school.
BMC Medical Education,
23
, 1-11.
https://doi.org/10.1186/s12909-023-
04044-3
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