The U.S. Heathcare System HCAD 620 Mid-Term Examination INSTRUCTIONS: Develop a
The U.S. Heathcare System
INSTRUCTIONS: Develop a policy analysis based on the scenario presented below. The product should
be a minimum of 5 and a maximum of 12 pages (excluding cover page, appendices, charts, and
references), double spaced, conforming to APA standards.
NOTE: Some of the facts in this scenario are hypothetical; others are actual.
As a mid-career health analysis, you have recently been
hired as the Health Policy Coordinator for the Alliance for
Rural Health. The Executive Director of the Alliance has
requested that you prepare a policy briefing discussing
the delivery of Health Care Services to the residents of
The Appalachian region of Kentucky is comprised of 54 counties with a total population of approximately
1.2 million. In Appalachian Kentucky, 100% of the population would be considered rural by Federal
standards, as only 2.6% live in a town of 20,000 or more, the single incident of Richmond city. The
average adult in Appalachian Kentucky reports feeling physically unhealthy 47% more often than the
average American and 23% more often than the average adult in non-Appalachian Kentucky. The
average adult in Appalachian Kentucky reports feeling mentally unhealthy 25% more often than the
average American and 15% more often than the average adult in non-Appalachian Kentucky.
In addition, recent surveys of the behavioral health system, clinics, and tribal health center report
significant rates of depression, post-traumatic stress disorder, schizophrenia and substance abuse /
dependence among Appalachian Kentucky residents. There is concern that these problems are related
to high rates of suicide and domestic violence.
Finally, other reports from social service agencies report that there is a significant population in the region
that is effectively homeless, living seasonally (or sometimes year-round) in campers, tents, or out of
automobiles, moving between campgrounds or camping areas in the state park grounds. This population
includes families with children in some cases.
The paper should accomplish the following:
1. Discuss the problem of underserved populations and subgroups, including characteristics of
those groups and barriers to delivery.
2. Examine the structure of the delivery system and how this helps or hinders health delivery.
3. Discuss the impact of ACA.
4. Make clear recommendations as appropriate for meeting the health delivery challenges of