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Policy Paper: PH3815 Health Policy Analysis (Kraft Evaluative Criteria…
Policy Paper:
PH3815 Health Policy Analysis
Alternatives (facility-oriented, not services-based)
No change, let market forces define the local services
Restore funding for Medicare and Medicaid supplemental funding
Establish telemedicine resources for each rural area
Partner with larger hospital systems for free-standing ED/ASCs
Incentivize more mid-level providers to open practices in rural areas
Outcome Measurement
amount of hospital funding
distance to nearest hospital
type of hospital services lost
type of services needed for rural areas
number of local providers
Too many rural Texans are losing access to nearby hospital/emergency department services
Number of rural hospitals closing over the past 5 years
Lack of Medicaid supplemental funding: Root Cause Analysis
Disproportionate Share Hospital Funding cut
Fed govt cut funding by 14 percent
expected to be balanced by Medicaid expansion from ACA
Medicaid 1115 Waiver 5-year window
Fed govt provided safety net funding for 5 years from 2011-2016, extended
What Do Governments Do?
Kraft
government management
education/inform/persuade
tax/spend
modify market mechanisms
regulate
Bardach
tax/subsidize
provide services/management
regulate
information
insure rights via legal processes
affect economic activity mechanism
modify government or its bureaucracies
Kraft Evaluative Criteria
Liberty
Political feasibility
Equity (rural population)
Social acceptability
Efficiency (inefficient to sustain rural hospitals)
Administrative feasibility
Effectiveness
Technical feasibility
After prescription: Dunn Structure of Policy Arguments, CH8
Qualifier
Information
Objection
Warrant
Backing
Rebuttal
Claim