An Introduction to Health Policy and Management

Understanding Health Policy Development

Public health research is essential to health policy development. Researchers and policy experts will identify issues that need consideration, test evidence-based or new interventions, and let the data inform the policy construction. Once implemented, experts will test policy rollout and efficacy through policy analysis. For example, there are federally regulated health policies to ensure our food is safe, individuals cannot drive after a certain amount of alcohol, and employees cannot work over a certain amount of hours per week. These policies were heavily researched and are evidence-based solutions to common public health issues. 

The Role of Health Management in Service Delivery

Health systems often have multi-billion dollar operating budgets and a massive influence in their local communities. There is a bidirectional influence between health systems and local and federal policies. When policies change, health systems and health managers in service delivery can be the first to feel the effects. For example, numerous health policies ensure patients have unbarriered access to their personal health information.³

There are various policies to ensure the protection and privacy of patients’ personal health information.⁴ Besides privacy, considerable policies regulate the quality, accessibility, and availability of service delivery. Aside from regulations and policies, healthcare management has autonomy over service delivery. Hospital leadership can decide, with stakeholder input, of course, which insurance they want to accept, if they will operate with a lean Six Sigma model, and the health services they provide (i.e., adding telemedicine, home health, or advanced diagnostic testing).

In addition to their operating autonomy, large health systems can also affect local, state, and federal public policy. For example, health care providers can contribute to the advocacy efforts for Medicaid to cover certain services, like street medicine.⁶ This all culminates in public health management playing a large role in service delivery. 

Navigating Healthcare Systems and Structures

The United States has a notoriously complex health care system.⁵ We have multiple options for insurance - public insurance that is publicly funded, such as Medicaid and Medicare; private insurance that is publicly funded, through the state or federal marketplace; and private insurance that is privately funded, which is often through an employer or directly through the insurance company. There are multiple ‘tiers’ or levels to insurance, supplemental plans, separate dental and vision plans, and the list goes on. Healthcare management organizations can ease the burden of navigating these complex systems by providing case managers, patient navigators, and community health educators to guide folks through the system. 

The Influence of Socio-Economic and Political Factors on Health Policy

Health policy continuously changes and iterates with our evolving socio-economic and political environments. Each new political administration, at the local, state, and federal levels, usually tweaks health policies to their liking. Large-scale policy changes, like the Patient Protection and Affordable Care Act in 2010, to smaller-scale policy changes, like Pennsylvania transitioning from a Federally Facilitated Marketplace to a State-Based Marketplace, both significantly impact their respective constituents. As the country continues to evolve, research, and learn more, public health policy will continue to iterate and develop to meet constituents’ wants and needs. 

How Health Policy Shapes Public Health Initiatives

The CDC defines health policies as “formal or informal written statements designed to protect or promote health”.⁷ Health policies are formulated through careful research and shape public health initiatives. Two examples of recent health policies that shaped public health initiatives were the COVID-19 vaccine mandate and subsequent public health campaigns and the cigarette tax and subsequent tobacco cessation funded programs and anti-smoking campaigns.   

Impact on Healthcare Access and Equity

Health policy and healthcare management play significant roles in health care, access, and equity. Healthcare providers play a major role in communities. They are often large, staple organizations that have relationships with local government, small businesses, and non-governmental organizations. The federal government mandates all non-profit hospitals to complete community health needs assessments and implementation plans to address the needs of their surrounding communities.

This requires healthcare providers to become aware of and address their community’s needs in an equitable and accessible way. If the community health needs assessment depicts a lack of access to mental health services in a certain neighborhood, the health system must either provide those services or help connect individuals to an institution that can provide them. 

The Role of Health Management in Optimizing Healthcare Delivery

We know that health systems play a primary role in health care delivery. There are many ways to optimize this delivery, including taking a holistic approach to care, integrating additional service providers (i.e., social workers, case managers, etc.), and addressing needs identified by the community. Health administration leaders are obligated to optimize their healthcare delivery in an equitable, high-quality, and accessible way. 

Addressing Health Disparities Through Policy Interventions

Public health research highlights, and subsequently, through policy interventions, helps eliminate health disparities. Research assistants and healthcare policy experts study health outcomes across demographic groups at the population health level to identify disparate outcomes, unequal access, and ineffectual interventions. They use these findings to change policies that hopefully improve health equity.

Educational Pathways and Qualifications

According to the CDC, some of this century's greatest health policy achievements have been related to vaccine preventable diseases, motor vehicle safety, and tobacco control.⁹

Advocacy is imperative to effect health policy change. It takes action, insight, and advocacy to transform an idea or research into political action effectively. To ensure effective policy implementation, use strategies such as clear communication (low literacy level, in multiple languages, and through multiple channels (i.e., online, radio, social media, print)), being transparent and accountable for the policy suggestions, and monitoring and evaluation of community and constituents interests.

It’s important to balance public interest with political realities; we want the policy changes to align with most of the public’s interest, or, at least, as close as we can get it.

Health policy and management plays a vital role in society and is a ripe field for public health professionals. As there are endless policies that can be researched and enacted, consider exploring a career in this growing field. Whether or not you decide to become a policy expert or healthcare manager, all public health professionals are responsible for supporting effective health policy initiatives that will improve the daily lives of our communities.