Policy and Advocacy for Improving Population Health







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Assignment: Assessing a Healthcare Program/Policy Evaluation


Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role in assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.




To Prepare:

Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

  • Describe the healthcare program or policy outcomes.
  • How was the success of the program or policy measured?
  • How many people were reached by the program or policy selected?
  • How much of an impact was realized with the program or policy selected?
  • At what point in program implementation was the program or policy evaluation conducted?
  • What data was used to conduct the program or policy evaluation?
  • What specific information on unintended consequences was identified?
  • What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
  • Did the program or policy meet the original intent and objectives? Why or why not?
  • Would you recommend implementing this program or policy in your place of work? Why or why not?
  • Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.






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Policy and Advocacy for Improving Population Health





In the past years, efforts to implement the quality of care and reduce costs have resulted in adopting new policies and legislation. In this case, health care policies are designed to meet the population's needs and specific context. However, health policy has an attribution problem due to multiple systems that affect health outcomes. In this regard, situation and context tend to vary from one location to the other, and the impacts of the Intendended policies may not yield the required goals. Thus, policy reforms choices, outcomes of interest, and data are essential in the evaluation process to determine the impacts and outcomes of a given health policy.

Health Care Policy

Children’s Health Insurance Program (CHIP)



CHIP programs were designed to provide health care to children living in low-income households. In this regard, the CHIP health care policy originated from the children's Health insurance authorization act of 2009(Perrin & Hall, 2015). Thus, the primary objective of the CHIP policy is to provide insurance cover to unprivileged children by accruing funds from the federal and state.

Policy Outcomes

Studies in California revealed that the implementation of the CHIP policy was correlated with a reduction in hospitalization, suggesting that primary access and quality for low incomes improved (Paradise, 2014). Besides, another study found a 10% point increase in CHIP eligibility from 30% of children to 40%. Thus, the policy has impacts on children's health and a reduction in the rate of mortality. Besides, the program also increased access for children with chronic and special health care needs.

Success Measures

The success of the policy was measured based on the reported number of child mortality rates and the rate of hospitalization among children from low-income families (Paradise, 2014). Also, the rate of success was measured based on the use of prevention and primary care.

People reached

The CHIP program is administered in each state in adherence to federal laws (Medicaid.gov, 2015). After implementation, over 9.6 million children were enrolled in the programs.

Data used in the evaluation

Data from the uninsured population was used to conduct the CHIP program. In this regard, the CHIP program was a block grant and not an entitlement program. Thus, data from the uninsured population in the respective state formed the basis of the program's evaluation.


The stakeholders in the programs evaluation were both federal, state, and health players in the health care settings. In particular, due to the nature of the finding, the federal governments were the major stakeholders.

Unintended Consequence

The increased public coverage depicted the consequence of the CHIP program by 14-20% and a decline in ESI of the 7 percentage points. Besides, the reduction in insurance of between 7 and 13 % points was a positive but unintended consequence (Dubay & Kenney, 2009). Other benefits were depicted by the improved quality of life among children from low-income groups and resultant decreased hospitalization rates. It was also reported that the out-of-pocket expenses and medical expenses decreased with implementing the CHIP program among the low-income groups. However, the program's implementation in some states did not correlate with the administrative data(Paradise, 2014). In particular, in the state of Virginia, the progress for child coverage was inconsistent. In essence, the Current population survey revealed that the enrollment of children in insurance programs increased during the implementation of the CHIP while the administration date showed a decline. Additionally, Paradise (2014) reported that premiums, deductibles, and cost-sharing were low in the CHIP program. The other negative impact is associated with the low dentist participation in CHIP.

Intent and objective

Originally, the programs were designed to cater to the health care needs of children from low-income groups who Medicaid and Medicare sidelined. Besides, the other objective was to provide cost-effective healthcare programs to families that could not afford other forms of insurance. Based on past studies and the impacts of the programs, it can be argued that the program's objectives and the intent were achieved(Dubay & Kenney, 2009). The increased insurance rates depict this among the children and better outcomes in terms of health care utilization. It was also reported that child and maternal health also improved significantly. Paradise (2014) also mentioned that state policymakers, advocates, and child coverage experts were the crucial stakeholders that leveraged CHIP data in decision-making. Apart from the health access intent, the programs also cautioned families from low-income groups.


To improve the efficacy of the CHIP programs, there is a need to regulate the entry eligibility to prevent covering children above the 250 poverty level. Also, both state policymakers and the censuses bureau should be involved in the decision-making aspect of the CHIP to increase the efficacy of the programs and increase the positive outcomes through policy changes (Dubay & Kenney, 2009). Besides, there is a need for frequent state surveys to assess the impacts of the programs on the targeted population. The county data can also be used to evaluate the program's outcomes and the need for policy changes to address the existing gaps. Overall, I would recommend implementing the program at my workplace among employees who cannot afford insurance cover offered by Medicaid and Medicare providers.

Roles of nurse advocate

Nurses play essential roles in addressing the need of the patient due to constant touch and interactions. In this case, I would actively participate in meetings and discussions across the states to ensure that barriers in implementing the programs are omitted. Besides, public education is an important aspect that contributes to the uptake of given health programs. In this case, I would engage in public education among the low-income groups and provide insight on the importance of insurance among marginalized communities. Education and policy meetings can address areas that need improvement based on the data accrued from the evaluation process and my professional input.





Policy evaluation plays an essential role in addressing the gaps in ensuring program success and outcomes. During the evaluation process, data based on the context or the situation governing the population affected by the policy should be given priority. In this regard, the CHIP policy evaluation should be carried out within low-income population groups. It is also important to note that data from case studies can also be used in the evaluation process. However, aspects related to the program's developmental phase should also be considered during the evaluation process.








Council (US), N. R. (2010). Using Uninsured Data to Track State CHIP Programs. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK209609/

Dubay, L., & Kenney, G. (2009). The Impact of CHIP on Children’s Insurance Coverage: An Analysis Using the National Survey of America’s Families. Health Services Research, 44(6), 2040–2059. https://doi.org/10.1111/j.1475-6773.2009.01040.x

Medicaid.gov. (2015). Children’s Health Insurance Program (CHIP) | Medicaid.gov. Medicaid.gov. https://www.medicaid.gov/CHIP/index.html

Paradise, J. (2014, July 17). The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us? - Issue Brief. The Henry J. Kaiser Family Foundation. https://www.kff.org/report-section/the-impact-of-the-childrens-health-insurance-program-chip-issue-brief/

Perrin, J. M., & Hall, R. (2015). The Children’s Health Insurance Program Strengthens Children’s Health Care. Academic Pediatrics, 15(3), S11–S12. https://doi.org/10.1016/j.acap.2015.03.003





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