Module 2 Assessment: Legislation Comparison Grid and Testimony/Advocacy Statement

Posted: March 17th, 2024

NURS 6050 Legislation Comparison Grid Template Sample Answer Guide.

**Legislation Comparison Grid Template**

**Health-related Bill Name: Nurse Practitioner Scope of Practice Expansion (2024)**

* Connects to nurses’ roles within healthcare systems (relevant to course focus).
* Recent bills in some states address expanding NPs’ practice authority (relevant to 2024 and specific location needed).

**APA Reference:** American Association of Nurse Practitioners. (2024, February 14). State Scope of Practice Laws. https://www.aanp.org/advocacy/state/state-practice-environment

**Bill Number**
S.B. 1246

**Description**
A bill to amend the Nurse Practice Act to remove the requirement for nurse practitioners (NPs) to have collaborative practice agreements with physicians in order to provide comprehensive health care services.

**Federal or State?**
State (Applicable state to be specified)

**Legislative Intent**
The intent of the bill is to expand the scope of practice for NPs, allowing them to practice to the full extent of their education and training without mandated physician oversight. This aims to increase access to primary care services, particularly in underserved areas.

**Proponents/Opponents**
Proponents:
– State Nurses Association
– American Association of Nurse Practitioners
– Patient advocacy groups

Opponents:
– State Medical Society
– American Medical Association

**Target Population**
The general population, particularly residents of rural and underserved areas with limited access to primary care providers.

**Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)**
The bill has been introduced in the state legislature and is currently under review by the Health and Human Services Committee. It has received moderate press coverage from local news outlets, highlighting the debate between nursing and medical associations.

**General Notes/Comments**
Supporters argue that removing collaborative practice agreements will improve healthcare access and allow NPs to practice to their full potential, while opponents raise concerns about patient safety and quality of care without physician oversight.

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Assignment Writing Guide

Module 2 Assessment: Legislation Comparison Grid and Testimony/Advocacy Statement

The daily realities of nursing often ignite a passion for advocacy. Nurses witness firsthand the impact of healthcare policies, laws, and regulations. Through venturing into the unfamiliar territory of policy and politics, nurses can shape the future of healthcare for the better.

Simplified Instructions Guide:
To Prepare:

Using the congressional websites provided in the Learning Resources, select a proposed health-related bill (not one that has already been enacted). i.e.
Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

The Assignment: (1-2 page Comparison Grid; 1-2 page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Template:

Bill Title: (Insert the title of your chosen bill here)

Legislative Intent: Briefly summarize the bill’s intended outcome or goal.

Proponents/Opponents: Identify the main groups or individuals supporting and opposing the bill.

Target Population: Specify the groups or individuals the bill aims to impact.

Legislative Stage: Indicate the current status of the bill (e.g., introduced, committee hearings, voted on by the House/Senate).

Press Coverage: Mention any significant media attention the bill has received.

Part 2: Legislation Testimony/Advocacy Statement

Template:

Bill Title: (Repeat the title of your chosen bill)

Position: State your stance on the bill (support or opposition).

Supporting Arguments: Explain the reasons behind your position, highlighting the positive effects of the bill if you support it or outlining the potential drawbacks if you oppose it. Use data, statistics, or personal anecdotes to strengthen your arguments.

Addressing Opponents: Acknowledge potential concerns regarding the bill from the opposing viewpoint. Provide counterarguments or propose solutions to address these concerns.

Recommended Amendment: Suggest at least one amendment to the bill that aligns with your position and explain how it would improve the legislation.

Remember:

Aim for a total length of 2-4 pages for the entire assignment.
Use clear and concise language throughout the document.
Include citations for any referenced data or information.
This framework equips you to analyze a proposed health-related bill, advocate for your perspective, and potentially influence the future of healthcare policy.

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Legislation Comparison Grid Template (Sample Guideline – use it to write the answer)

Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement

Health-related Bill Name

Bill Number
Description

Federal or State?
Legislative Intent

Proponents/ Opponents Proponents:

Opponents:

Target Population
Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)

General Notes/Comments

Write the Legislation Testimony/Advocacy Statement:

Study Notes for the bill:

The Healthcare Access and Affordability Act of 2024: Analysis and Implications

Abstract
The Healthcare Access and Affordability Act of 2024 represents a major expansion of health coverage and consumer protections in the United States. This paper provides an overview and analysis of the Act, examining its legislative intent, key provisions, anticipated impact on the healthcare system and target population, and the political and regulatory issues surrounding its implementation. Scholarly references published between 2018-2024 are cited to support the analysis.

1. Introduction
On [DATE], the Healthcare Access and Affordability Act of 2024 was signed into law, marking a significant milestone in healthcare reform in the United States. The Act aims to address long-standing challenges related to access, affordability, and quality of care for millions of Americans. It expands coverage through both public programs like Medicaid and private sector reforms (U.S. Congress, 2024).

This paper presents a comprehensive analysis of the Act, beginning with an overview of its main components in Section 2. Section 3 examines the legislative intent and stated goals of the Act. Section 4 analyzes key provisions, organized by the Act’s different titles. Implications for the U.S. healthcare system, including impacts on consumers, providers, and payers, are discussed in Section 5 along with political, regulatory and business issues related to implementation. Section 6 identifies major proponents and opponents of the bill. Finally, Section 7 explores the anticipated impact on the target population based on early projections and analyses.

2. Overview of the Act
At its core, the Healthcare Access and Affordability Act establishes healthcare as a right for all Americans and lays out a multi-pronged strategy to achieve universal coverage. The Act expands Medicaid eligibility, provides new subsidies for purchasing private insurance, and implements market reforms to protect consumers and improve quality (Kaiser Family Foundation, 2024). It also establishes state-based health insurance exchanges where individuals and small businesses can shop for affordable, qualified health plans.

3. Legislative Intent and Goals
According to the text of the bill, the overarching goal of the Act is to “increment the common good health of United States residents” by expanding access to quality, affordable healthcare while controlling costs (U.S. Congress, 2024). Specific objectives include:

– Increasing the number of insured Americans and reducing the uninsured rate
– Expanding public programs like Medicaid and CHIP
– Providing tools to reform the private insurance market
– Supporting disease prevention and reducing health disparities

The Act reflects a belief that universal healthcare is both a moral imperative and sound economic policy. Legislators sought to build on prior state-level reforms while introducing new consumer protections at the federal level (Chalasani, 2024).

4. Key Provisions by Title
Title I of the Act expands Medicaid to cover all individuals under age 65 with incomes up to 133% of the federal poverty level. It provides enhanced federal funding to states to support this expansion (Center on Budget and Policy Priorities, 2024).

Title II establishes American Health Benefit Exchanges in each state to facilitate the purchase of qualified health plans. Plans sold on the exchanges must meet certain requirements, such as covering essential health benefits and following rules on premium rating. Importantly, plans cannot be excluded from the exchanges based on their affiliation with a religious institution like Notre Dame (Rosenbaum, 2024). Premium and cost-sharing subsidies are available to make exchange plans more affordable.

Title III enacts insurance market reforms such as prohibiting denial of coverage or higher premiums based on preexisting conditions or gender. It also limits age rating and requires plans to offer dependent coverage up to age 26.

Other key provisions include an individual mandate requiring most Americans to have health insurance or pay a penalty, as well as an employer mandate for businesses with 50 or more employees to offer coverage or face penalties. The Act invests in public health and prevention, primary care, and health workforce development. It also includes delivery system reforms to promote quality and efficiency (Commonwealth Fund, 2024).

5. Implications for the U.S. Healthcare System
The Act is projected to dramatically reduce the number of uninsured while making coverage more secure and affordable for those who already have insurance. Lower-income Americans will gain coverage through the Medicaid expansion and exchange subsidies. Young adults will benefit from being able to stay on their parents’ plans. And individuals with preexisting conditions will no longer face discrimination (Tolbert et al., 2024).

For healthcare providers, the influx of newly insured patients may strain capacity in the short-term. However, increased coverage is expected to reduce uncompensated care costs and provide opportunities for service expansions. The emphasis on prevention and primary care could shift more care to outpatient and community settings over time (RAND Corporation, 2024).

Insurance companies will have to adapt to new regulations and subsidized competition from the exchanges. Some may choose to participate in the exchanges, while others may focus on employer-based and other market segments. New business opportunities could emerge for companies that can deliver innovative, cost-effective health solutions (PwC Health Research Institute, 2024).

Implementing the Act will require extensive coordination between federal and state agencies. States have flexibility in designing their Medicaid expansions and exchanges but must meet federal standards. Regulators will play a critical role in overseeing insurer compliance, defining essential health benefits, and approving premium rates (National Association of Insurance Commissioners, 2024).

Fiscally, the Act requires substantial federal investments to subsidize coverage expansions and implement reforms. Offsetting savings are projected from reducing uncompensated care, increasing prevention, and promoting value-based payment models. However, the net impact on the federal budget remains a point of debate (Elmendorf, 2024).

6. Proponents and Opponents
Proponents of the Act, including many Democrats and progressive advocacy groups, argue it represents a historic step toward guaranteeing healthcare as a basic right. They emphasize the moral and economic imperatives of universal coverage and point to popular provisions like protections for preexisting conditions. Supporters also highlight projected benefits such as improved financial security, health outcomes, and economic productivity (Rovner, 2024).

Prominent proponents include major physician groups like the American Medical Association and American Academy of Family Physicians, as well as patient advocacy organizations focused on specific diseases and populations. Unions, community health centers, and faith-based organizations have also endorsed the approach (Healthcare-NOW!, 2024).

Opponents, primarily Republicans and conservative groups, criticize the Act as government overreach that will disrupt existing coverage, reduce consumer choice, and strain the federal budget. They argue it fails to address fundamental cost drivers and could lead to rationing of care. Critics fear the employer mandate will burden businesses, while the individual mandate represents an infringement on personal liberty (Roy, 2024).

Key opponents include private insurance companies worried about competition from the exchanges and Medicaid expansion. Some physician groups have also expressed concerns about the adequacy of provider payments under reform. Conservative think tanks and advocacy organizations have mobilized to challenge the Act’s premises and provisions (Pipes, 2024).

7. Impact on the Target Population
While projections vary, the Congressional Budget Office estimates the Act will reduce the number of uninsured by 24 million over 10 years. Medicaid expansion alone is expected to cover 15 million low-income adults (Garfield et al., 2024). Over 9 million individuals are anticipated to gain coverage through the exchanges, with premium subsidies making plans affordable for most. The average subsidy will cover roughly two-thirds of the premium, with more generous assistance for those with lower incomes (Banthin et al., 2024).

The Act’s consumer protections will benefit millions more by prohibiting insurance discrimination, reducing cost-sharing, and improving coverage security. For example, nearly 54 million non-elderly individuals with preexisting conditions will no longer face coverage denials or higher premiums. An estimated 14 million young adults will gain coverage on their parents’ plans (U.S. Department of Health and Human Services, 2024).

At the same time, 5 million individuals are expected to lose coverage from employer-sponsored insurance, as some firms may opt to drop plans and shift employees to the exchanges. This has led to concerns about disruptions for those who prefer to keep their current plans (RAND Corporation, 2024).

Expanded coverage is expected to improve access to care, health outcomes, and financial security for the newly insured. With coverage no longer tied to employment, individuals may experience greater job mobility and entrepreneurship opportunities. Increased prevention and primary care utilization could avert costly downstream complications (Commonwealth Fund, 2024).

However, the influx of demand may exacerbate existing provider shortages and appointment wait times in the short run (Petterson et al., 2024). Safety-net providers serving low-income communities will need to adapt to shifts in their payer mix and patient population (Kaiser Commission on Medicaid and the Uninsured, 2024). Outreach and enrollment efforts will be critical to ensure eligible individuals understand and take up new coverage options.

While the Act represents a major step forward, it is not a panacea for all of the health system’s challenges. Additional policy changes may be needed to address rising costs, disparities in care quality and outcomes, and population health needs. As with any large-scale reform, continued evaluation, refinement, and stakeholder engagement will be essential for successful implementation and sustainability.

References:
Banthin, J., Buettgens, M., & Damico, A. (2024). Subsidizing health insurance for low-income adults: Evidence from the Health Insurance Marketplace. Health Services Research, 59(3), 1056-1078. https://doi.org/10.1111/1475-6773.13935

Center on Budget and Policy Priorities. (2024). The Medicaid expansion in the Healthcare Access and Affordability Act. https://www.cbpp.org/research/health/the-medicaid-expansion-in-the-healthcare-access-and-affordability-act

Chalasani, P. (2024). The promise and challenges of healthcare reform in the United States: An interview with Dr. Pradeep Chalasani. Journal of General Internal Medicine, 39(6), 1289-1292. https://doi.org/10.1007/s11606-024-07015-6

Commonwealth Fund. (2024). The Healthcare Access and Affordability Act: How it works and what it means for the U.S. health system. https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/healthcare-access-and-affordability-act-how-it-works

Congressional Budget Office. (2024). H.R. 256, The Healthcare Access and Affordability Act. https://www.cbo.gov/publication/57234

Elmendorf, D. (2024). The Healthcare Access and Affordability Act: Fiscal implications and considerations [Testimony before the U.S. House Committee on the Budget]. Congressional Budget Office. https://www.cbo.gov/publication/57456

Garfield, R., Rudowitz, R., Guth, M., Orgera, K., & Hinton, E. (2024). Implications of the Healthcare Access and Affordability Act for states. Kaiser Family Foundation. https://www.kff.org/report-section/implications-of-the-healthcare-access-and-affordability-act-for-states-report/

Healthcare-NOW! (2024). The Road to Universal Healthcare campaign. https://www.healthcare-now.org/campaigns/road-to-universal-healthcare/

Kaiser Commission on Medicaid and the Uninsured. (2024). How the Healthcare Access and Affordability Act will impact safety-net providers (Issue Brief). Kaiser Family Foundation. https://www.kff.org/medicaid/issue-brief/how-the-healthcare-access-and-affordability-act-will-impact-safety-net-providers/

Kaiser Family Foundation. (2024). Compare proposals to expand public health insurance. https://www.kff.org/interactive/compare-proposals-to-expand-public-health-insurance/

National Association of Insurance Commissioners. (2024). Healthcare Access and Affordability Act: Overview and considerations for state insurance regulators. https://content.naic.org/sites/default/files/inline-files/HAA-Act-Overview-Considerations_0.pdf

Petterson, S., McNellis, R., Klink, K., Meyers, D., & Bazemore, A. (2024). The state of primary care in the United States: A chartbook of facts and statistics. Robert Graham Center. https://www.graham-center.org/content/dam/rgc/documents/publications-reports/reports/PrimaryCareChartbook2024.pdf

Pipes, S. (2024). The false promise of the Healthcare Access and Affordability Act. Forbes. https://www.forbes.com/sites/sallypipes/2024/06/15/the-false-promise-of-the-healthcare-access-and-affordability-act/?sh=1d4f3d6e1c1b

PwC Health Research Institute. (2024). The Healthcare Access and Affordability Act: Implications for the health industry. https://www.pwc.com/us/en/industries/health-industries/library/healthcare-access-affordability-act-implications.html

RAND Corporation. (2024). National health spending and the macroeconomic effects of the Healthcare Access and Affordability Act (Research Brief). https://www.rand.org/pubs/research_briefs/RBA1235-1.html

Rosenbaum, S. (2024). Ensuring equitable health care access: Nondiscrimination under the Healthcare Access and Affordability Act. The Commonwealth Fund. https://doi.org/10.26099/z9gc-rj89

Rovner, J. (2024). Analyzing the political prospects for the Healthcare Access and Affordability Act. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20240615.179281/full/

Roy, A. (2024). The folly of the Healthcare Access and Affordability Act. National Review. https://www.nationalreview.com/2024/06/the-folly-of-the-healthcare-access-and-affordability-act/

Tolbert, J., Orgera, K., & Damico, A. (2024). Key facts about the uninsured population. Kaiser Family Foundation. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

U.S. Congress. (2024). H.R. 256 – Healthcare Access and Affordability Act of 2024. https://www.congress.gov/bill/118th-congress/house-bill/256

U.S. Department of Health and Human Services. (2024). Fiscal year 2024 budget in brief: Healthcare Access and Affordability Act. https://www.hhs.gov/sites/default/files/fy2024-budget-in-brief.pdf

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NURS 6050N

Example Answer Paper for Legislation Comparison Grid and Testimony/Advocacy Statement – The Healthcare Access and Affordability Act of 2024.
Part 1- Legislation Comparison Grid and Testimony/Advocacy Statement

**Health-related Bill Name:** Healthcare Access and Affordability Act of 2024

**Bill Number:** TBD

**Description:** This bill aims to enhance the accessibility and affordability of healthcare services for all citizens, with a focus on expanding coverage, reducing healthcare costs, and improving the quality of care.

**Federal or State?:** Federal

**Legislative Intent:** The intent is to create a more equitable healthcare system that provides comprehensive coverage without financial barriers, ensuring that all individuals have the opportunity to receive necessary medical care.

**Proponents/Opponents:**
Proponents: Healthcare advocacy groups, medical professionals, general public
Opponents: Certain insurance companies, some business interest groups

**Target Population:** All U.S. residents with an emphasis on underinsured and uninsured individuals.

**Status of the bill:** Currently in committee hearings with moderate press coverage.

**General Notes/Comments:** The bill has garnered widespread support from various healthcare organizations due to its potential to significantly improve healthcare outcomes for millions of Americans.

Part 2: Legislation Testimony/Advocacy Statement

The Healthcare Access and Affordability Act of 2024 stands as a pivotal piece of legislation in the ongoing effort to reform the United States healthcare research paper writing help service system. With its comprehensive approach to addressing key issues such as coverage expansion, cost reduction, and quality improvement, the bill promises to transform the landscape of healthcare in America.
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Part 1: Legislation Grid

Legislative Intent:
The primary legislative intent of the Healthcare Access and Affordability Act of 2024 is to improve access to healthcare services, enhance the quality of care, and promote the overall health of the American population through comprehensive health insurance reform.

Proponents:

Democratic Party and liberal policymakers
Healthcare advocacy groups (e.g., American Heart Association, American Diabetes Association)
Providers and organizations within the healthcare industry

Opponents:

Republican Party and conservative policymakers
Some employers and business organizations
Individuals and groups advocating for a more incremental approach to healthcare reform

Target Populations:
Uninsured Americans
Low-income individuals and families
Individuals with pre-existing conditions
Small businesses and their employees

Current Status:
Based on the information provided, it is unclear where the Healthcare Access and Affordability Act of 2024 stands in the legislative process. The analysis does not specify whether the bill is currently in hearings, committees, or any other stage of the legislative process.

Part 2: Legislation Testimony/Advocacy Statement

As a healthcare advocate and a strong proponent of the Healthcare Access and Affordability Act of 2024, I firmly believe that this legislation is a critical step towards ensuring universal access to quality healthcare for all Americans. The current healthcare system in the United States is plagued by a myriad of challenges, including soaring costs, limited access, and disparities in care. The proposed Act seeks to address these issues head-on by expanding coverage, enhancing consumer protections, and promoting preventive care and wellness.

One of the most significant provisions of the Act is the establishment of the American Health Benefit Exchanges, which will serve as competitive marketplaces where individuals and small businesses can purchase affordable and comprehensive health benefit plans. This approach not only increases choice and accessibility but also fosters competition among insurers, ultimately driving down costs and improving the quality of coverage options (Blumenthal & Collins, 2017).

Moreover, the Act’s emphasis on expanding Medicaid and the State Children’s Health Insurance Program (SCHIP) is a vital step towards ensuring that low-income families and vulnerable populations have access to essential healthcare services. By raising the income threshold for Medicaid eligibility, millions of Americans who previously fell through the cracks will now have a safety net, allowing them to seek preventive care and manage chronic conditions effectively (Sommers, 2020).

Opponents of the Act have raised concerns about potential disruptions to the existing employer-based insurance system and the perceived risk of reduced choices in the healthcare market. However, these concerns are unfounded. The Act does not seek to dismantle the current system but rather aims to complement it by providing additional options and safeguards. Furthermore, the legislation includes provisions that incentivize employers to offer comprehensive healthcare coverage to their employees, ensuring a smooth transition and minimizing potential disruptions (Oberlander, 2019).

To address the concerns of opponents, it is crucial to emphasize the long-term benefits of the Act. By expanding access to preventive care and promoting early intervention, the legislation has the potential to significantly reduce the burden of chronic diseases and associated healthcare costs. Additionally, the Act’s focus on quality improvement and consumer protections will ultimately foster a more efficient and patient-centered healthcare system, benefiting all stakeholders, including providers, payers, and employers (Sommers et al., 2017).

Addressing Concerns and Highlighting Benefits of the Healthcare Reform Act

Concerns have been raised by opponents of the Healthcare Reform Act regarding potential disruptions to the existing employer-based insurance system and the perceived risk of reduced choices in the healthcare market. However, these concerns are misplaced, as the Act is designed to complement the current system rather than dismantle it. The legislation includes provisions that encourage employers to provide comprehensive healthcare coverage to their employees, ensuring a smooth transition and minimizing potential disruptions (Oberlander, 2019). The Act aims to expand options and safeguards for consumers, ultimately enhancing the overall healthcare system.

To alleviate the concerns of opponents, the long-term benefits of the Healthcare Reform Act must be emphasized. By expanding access to preventive care and promoting early intervention, the legislation has the potential to significantly reduce the burden of chronic diseases and associated healthcare costs (Sommers et al., 2017). The Act’s focus on quality improvement and consumer protections will foster a more efficient and patient-centered healthcare system, benefiting all stakeholders, including providers, payers, and employers (Collins et al., 2019). Additionally, the legislation’s provisions for increased transparency and accountability in the healthcare industry will help to ensure that consumers have access to the information they need to make informed decisions about their healthcare (Blumenthal et al., 2020). By addressing these key issues, the Healthcare Reform Act represents a significant step forward in improving the US healthcare system (Fiedler, 2021).

Therefore, the Healthcare Access and Affordability Act of 2024 represents a historic opportunity to reshape the American healthcare landscape and ensure that every citizen has access to quality, affordable care. While the implementation of such a comprehensive reform may present challenges, the potential benefits to individuals, families, and the nation as a whole far outweigh any temporary disruptions. Through working collaboratively with all stakeholders and addressing legitimate concerns through open dialogue and evidence-based solutions, we can pave the way for a healthcare system that truly serves the needs of all Americans.

References:

Blumenthal, D., Collins, S. R., & Fowler, E. J. (2020). The Affordable Care Act at 10 years: What’s the effect on health care coverage and access? Commonwealth Fund. https://doi.org/10.26099/9rzm-ky94

Collins, S. R., Gunja, M. Z., & Aboulafia, G. N. (2019). The Affordable Care Act at 10 years: Coverage gains and the road ahead. Commonwealth Fund. https://doi.org/10.26099/qyx5-2v60

Fiedler, M. (2021). How would the American Rescue Plan Act affect health insurance coverage? USC-Brookings Schaeffer on Health Policy. https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2021/03/11/how-would-the-american-rescue-plan-act-affect-health-insurance-coverage/

Oberlander, J. (2019). The ten years’ war: Politics, partisanship, and the ACA. Health Affairs, 38(9), 1441-1446. https://doi.org/10.1377/hlthaff.2019.00916

Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health — What the recent evidence tells us. New England Journal of Medicine, 377(6), 586-593. https://doi.org/10.1056/nejmsr1706645

Wilensky, G. R., & Berenson, R. A. (2021). The future of healthcare delivery and payment reform: A need for bipartisan action. Health Affairs Blog.