Health Care Policy Analysis: CMS

Topic: Administration
Words: 966 Pages: 3


Health policy analysis addresses the key problem of CMS contribution and the dynamic challenges posed by population demographics. Marć et al. (2019) argue that the age group highly affected by the healthcare policy is the elderly, mainly because of the lack of clarity in the standards of healthcare operations. The aging nurses further encounter a key challenge from the health policy since it falls short of such expectations as addressing the disability retirement conditions and approaches to prevent the outcome. Efficiency in the healthcare department depends on the regulations, outreach, and programs as the circumstances of the key legal issue (Teitelbaum & Wilensky, 2020). Verma presents a controversial work requirement to enhance the significant impact of the Medicaid stamp. There is also a plan of shifting the present Medicaid funding specifically to a block grant exemplary. One of the main issues in the financial management of Medicaid resources involves the budgeting limits on direct safety-net health programs, especially for the dynamic population. Effective healthcare management is the involvement of all stakeholders, such as CMS, and the federal government in the decision-making process to improve the sustainable growth in the effectiveness of Medicaid.

Healthcare Policy Question

What is the significant challenge posed by healthcare policy in addressing the standards of care for the aging population and participation of the CMS?


The Center for Medicare and Medicaid Services (CMS) is more concerned with the act of administering the world’s major health programs. Another role for CMS is the management of the insurance policies for American citizens. The organization is also concerned with collecting and analyzing data and producing various research reports. President Lyndon B. Johnson, on 30th July 1965, took part in the establishment of Medicaid and Medicare programs (Leonard et al., 2017). In 1977, the agency established the Health Care Finance Administration (HCFA) as the primary part of the Department of Health, Education, and Welfare (HEW). Further, HCFA was named as CMS to successfully manage various beneficial national health care programs influencing millions of Americans.

However, CMS is greatly concerned with managing the Administrative Simplification Standards associated with the Health Insurance Profitability and Accountability Act (HIPPA). The Administrative Simplification Standards’ primary usage is the critical implementation of the adoption conducts related to the national electronic health care records, enforcing the HIPPA rules, and guaranteeing patients’ security and privacies. The integral participation of all stakeholders in the implementation process of the policy is a sustainable approach that boosts efficiency in service delivery (Teitelbaum & Wilensky, 2020). An interplay of both institutions’ roles fosters a sustainable improvement in the healthcare sector’s decision-making process with a profound support system from the technological tools.


Stakeholders, that is, God, government, American citizens, non-governmental organizations, healthcare practitioners, and foreign companies, contribute to society’s health landscape. The role of the partners involves mainly addressing the issue of quality assurance and management (Leonard et al., 2017). Teitelbaum and Wilensky (2020) further establish that the key participants in policy implementation, that is, the Governor’s office, the Patient and advocacy community, and the senior Medicaid and agency leadership influence medical care. The primary issue that impacts the quality and efficiency of the Medicaid policies is technology in service delivery. Pesapane et al. (2018) establish that artificial intelligence upgrades healthcare services quality mainly because of the cost-effectiveness and required resources for delivery. The primary regulatory instruments contributing to effective healthcare services are the decision-making process and service delivery tools, mainly artificial intelligence. Apart from the tools and policies, McDowell and South (2017) establish that the involvement of spiritual well-being in medical operations is a strategy that promotes effectiveness in the patients’ treatment. God states that the way an individual eats or drinks is praise for His glory (King James Bible, 2017, 1st Corinthians 10:31). It is essential to reconstruct the health landscape that appreciates God’s praise and as a major stakeholder. The healthcare landscape features a holistic approach in attaining the main objective of efficiency.


The CMS was once absent for admittance purposes due to the institutional policies and practices. CMS is recognized as the primary executive payer concerned with existing social insurance present in the United States of America (Leonard et al., 2017). Medicaid is a mainframe that profoundly influences the trickle-down health benefits to Americans. However, the above active projects are substantially regulated by the CMS. The agency ensures practical medical services applications by focusing on the critical human services costs recognized to influence their sustainability rate. Essentially, the concern of monetary challenges must be addressed by the CMS, which improves the essential eradication of inadequate health services to the patients. Thus, to address low health services, there is a need for the critical provision of payment services to medicinal suppliers.


The primary recommendation that can be articulated is to embrace CMS’s presence in the provision of esteem and critical-driven therapeutic activities. In this case, there will be a practical outline of various ventures for testing some ideas and strategies associated with giving adequate and reasonable social insurance measures. Apart from enhancing the participation and influence of CMS, it is important that the healthcare policy incorporate the use of a holistic approach for the operations. In this case, it is crucial to include God in the healthcare-based laws since it is a means of honoring His grace and mercy upon humankind. The standards are usually planned with the primary aim of giving and analyzing data to ensure success.

Concurrently, the final results tend to spread from the hospital sector, mostly from the top management to the employees. Compromising the management-related rules, specifically during the decision-making process, will contribute to the eradication of delays and incurrence of high costs in medical care and treatment. Thus, the appropriate recommendation measure is the adequate provision of efficient regulatory standards that enhance effective managerial functions.


King James Bible. (2017). King James Bible Online. Web. (Original work published 1769).

Leonard, C. E., Brensinger, C. M., Nam, Y. H., Bilker, W. B., Barosso, G. M., Mangaali, M. J., & Hennessy, S. (2017). The quality of Medicaid and Medicare data obtained from CMS and its contractors: Implications for pharmacoepidemiology. BMC Health Services Research, 17(1). Web.

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International Nursing Review, 66(1), 9-16. Web.

McDowell, L., & South, R. M. (2017). Christians’ perceptions of receiving spiritual care in the bible belt of the United States: A qualitative study of care provided in the healthcare setting. Religions, 8(7), 127. Web.

Pesapane, F., Volonté, C., Codari, M., & Sardanelli, F. (2018). Artificial intelligence as a medical device in radiology: Ethical and regulatory issues in Europe and the United States. Insights into Imaging, 9(5). Web.

Teitelbaum, J. B., & Wilensky, S. E. (2020). Essentials of health policy and law. Jones & Bartlett Publishers.

Wadhera, R. K., Figueroa, J. F., Maddox, K. E. J., Rosenbaum, L. S., Kazi, D. S., & Yeh, R. W. (2020). Quality measure development and associated spending by the centers for Medicare & Medicaid Services. Jama, 323(16). Web.

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