Envisioning and implementing new directions for health care.

Across the entire health sector, federal analysts indicate that in 2006 approximately $2.1 trillion were spent on health care, over $7,000 per person. With expenditures at this level, it is no surprise that people are asking whether the public receives value commensurate with the financial investment. While strides are being made on a number of quality of care fronts, given the financial resources being consumed, overall forward momentum is glacial. Educating the public is a particular challenge given amplified sound bites and attack ads designed to preserve the status quo. All of this underscores that nursing has a role not just in implementing new directions in health care but envisioning them as well.

Envisioning and implementing new directions for health care.

Across the entire health sector, federal analysts indicate that in 2006 approximately $2.1 trillion were spent on health care, over $7000 per person. With expenditures at this level, it is no surprise that people are asking whether the public receives value commensurate with the financial investment. While strides are being made on a number of quality of care fronts, given the financial resources being consumed, overall forward momentum is glacial. Educating the public is a particular challenge given amplified sound bites and attack ads designed to preserve the status quo. All of this underscores that nursing has a role not just in implementing new directions in health care but envisioning them as well.

Understanding the impacts of the Medicare Modernization Act: concerns of congressional staff.

Sweeping changes to the Medicare program embodied in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), including a new prescription drug benefit, changes in payment policies, and reform of the Medicare managed-care program, have major implications for rural health care. The most efficient mechanism for research to affect policy is to provide policy makers with information on issues about which they have voiced concern. The Rural Policy Research Institute's Health Panel conducted 2 focus groups with 16 congressional staff in September 2004 to identify a set of researchable questions concerning the impact of the MMA on rural health care. This paper presents research questions in the following areas that staff identified as having the highest priority: access to health plans and pharmacy services, beneficiary outreach and enrollment, technology capacity, provider payment policy, and demonstration projects.

A framework and action agenda for quality improvement in rural health care.

PURPOSE: The Agency for Healthcare Research and Quality and the federal Office of Rural Health Policy collaborated to convene an expert group to address issues of quality improvement in the rural health care environment. OUTCOMES: The group identified issues, barriers, and opportunities related to bringing rural health care into the mainstream of the national quality "revolution." A framework for rural quality and specific action steps was proposed. Recommendations were made in the areas of workforce, organizational performance, measurement, dissemination of innovation, and external factors impacting quality. Specific recommendations included fostering development of rural consortia, relevant quality measures for the rural environment, technical assistance capacity, appropriate financial incentives, leadership capacity, and databases.

The more things change.

The nursing profession's ability to influence public policy rests on individual as well as collective actions. Given Web-based information resources available today, nurses, regardless of where they reside, can be informed and engaged in health policy.