Clinical Services and the Regulatory Environment: An Overview

ABSTRACT

Most clinicians have difficulty participating in the political process. Patients/clients come first, and there is often little time to pursue information about the political and regulatory processes affecting clinical practice. Yet, such activity is imperative if speech-language pathologists and other practitioners want to achieve individual and collective professional goals and ensure sufficient funding for services to consumers. This article is an overview of politics, health-care policy, and regulation. Definitions are presented, and concepts regarding how politics become policy are cast in the familiar structure-process-outcome triad. Four types of regulation are discussed, and current regulatory initiatives are explained from the perspective of policy-makers. The discussion concludes by applying these concepts to issues and behaviors of specific interest to speech-language pathologists and sets the stage for the other articles in this publication.

KEYWORDS

Health-care regulation - speech-language pathology - political process

REFERENCES

• 1 Skolimowski H. The meaning of politics in a spiritual perspective. Renaissance Universal. http://Available at www.ru.org/artmea.html Accessed November 16, 2005
• 2 Donabedian A. Evaluating the quality of medical care.  Milbank Mem Fund Q. 1966;  44 166-206
• 3 Friedman J. Legislative advocacy, policy, and politics. Presented at: Medical Center Administrator's Meeting. Dec. 1, 2005 Columbus, OH;
• 4 Brown L D. Political evolution of federal health care regulation.  Health Aff. 1992;  11 17-37
• 5 CMS administrator says agency is working to reduce distortions in Medicare payments, foster integration of post-acute settings. Deloitte Health Care Review. July 2005 http://Available at: www.deloitte.com Accessed November 20, 2005
• 6 General Accounting Office. Little progress made in targeting outpatient therapy payments to beneficiaries' needs. Highlights of report number GAO-06-59 November 10, 2005 http://Available at: www.gao.gov/cgi-bin/getrp?GAO-06-59
• 7 Complying with increasingly complex regulatory requirements means first “connecting all the dots.” Deloitte Health Care Review February 2005. http://Available at: www.deloitte.com Accessed on December 2, 2005
• 8 Fody K. HIPAA compliance not so great? Maybe it's time to coordinate.  Healthc Financ Manage. 2004;  58 84-86
• 9 O'Neill T, Hymel G. All Politics Is Local and Other Rules of the Game. Holbrook, MA; Bob Adams 1994