Healthcare resource allocation decisions affecting uninsured services
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 21 November 2016
Abstract
Purpose
Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions.
Design/methodology/approach
The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders.
Findings
Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values.
Research limitations/implications
Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members.
Practical implications
Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements.
Social implications
The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions.
Originality/value
This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services.
Keywords
Acknowledgements
The authors would like to thank the study participants and the hard work of people who run Community Access Programs and other safety net programs to provide people with access to healthcare. The authors would also like to thank Drs Anne Riley, Shannon Frattaroli, Maria Merritt, Ruth Faden, David Holtgrave, Bradley Herring, Carlton Haywood Jr, and Jessica Holzer for their feedback on earlier versions of this work. Dr Harrison was supported by the AHRQ NRSA Health Services Research and Policy Traineeship (No. T32-HS00029) and the Victor P. Raymond Memorial Fund Health Policy and Management Endowment Award when conducting this work, and is currently supported by the National Institute of Aging (No. T32-AG000212).
Citation
Harrison, K.L. and Taylor, H.A. (2016), "Healthcare resource allocation decisions affecting uninsured services", Journal of Health Organization and Management, Vol. 30 No. 8, pp. 1162-1182. https://doi.org/10.1108/JHOM-01-2016-0003
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited