The ACA – An Intersection between Health Policy and Community Health

In order to achieve the goal of all U.S. residents having access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market, the Affordable Care Act (ACA) also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages.  With the vision set forth by the creation of these policies, inevitably there has to be means to bring it to fruition.  Many would say that this is where there is a usual disconnect between the vision and execution.  However, implementation of the ACA is an example of the concerted efforts between the policy side and the community health / outreach side to increase access and make healthcare affordable.

The World Health Organization defines health policy in this way:

Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people.^[1]

By definition, community health is a field within public health concerned with the study and improvement of the health of biological communities defined mostly by geography or specified needs.  In the case of the ACA, the terms community health and community outreach can be used interchangeably.  Community outreach involves getting information and services to consumers timely and can be effective in helping hard-to-reach consumers.

The goals of community outreach are to:

• Increase awareness about the Affordable Care Act, including the requirements for individuals and small employers
• Improve understanding about the health coverage options available and where consumers can go for help
• Encourage consumers to take action to enroll in health coverage for themselves or their employees

Health care takes place within a complex policy framework that addresses access, cost and quality and that defines the duties of the health care system where protection of the public’s health and prevention of disease are concerned.  In order to carry out the fundamental assurances that lie at the heart of public health, public and community health professionals need to be intimately familiar with the role of health policy in shaping public health functions and the health care enterprise.  For true health reform to take place, there must be a mutual recognition and acknowledgment of the roles both health policy and community health play to initiate change.

Cognosante has deep involvement in the planning and implementation of the ACA making the company the arbiters of the intersection between policy and community health. Using innovative approaches, Cognosante demonstrates that it is possible translate policy into action.  Innovation throughout Cognosante’s lines of business demonstrates that Cognosante is not only the best minds on health in the information technology space; Cognosante is simply the best minds on health.

[1] http://www.who.int/topics/health_policy/en/