Center for the Future of the Health Professions Jan. 2025 digest
Posted: January 22, 2025
The Center for the Future of the Health Professions, dedicated to providing policymakers and healthcare stakeholders with comprehensive data for effective planning, presents our first op-ed column for 2025 focusing on healthcare professional advocacy.
This comprehensive article explores the vital role of advocacy in healthcare professions, examining how healthcare professionals can influence policy and improve patient care through organized action. From state-level advocacy structures to national policy initiatives like the Affordable Care Act, the piece provides a detailed roadmap of how healthcare professionals can effectively engage in advocacy efforts. Through practical examples and case studies, readers will gain insights into critical issues facing healthcare advocacy today, including third-party payor reimbursement, Medicaid coverage limitations, and the ongoing debates around scope of practice expansion.
Our guest author, Amanda L. Weaver, MBA, brings two decades of experience as executive director of the Arizona Osteopathic Medical Association (AOMA), where she worked extensively with osteopathic physician leaders to improve healthcare access and quality in Arizona. Her involvement in various healthcare initiatives, from e-health information exchange to graduate medical education, alongside her completion of the American Osteopathic Association’s Health Policy Fellowship Program, provides valuable perspective on effective healthcare advocacy. As the current program manager for A.T. Still University’s Center for the Future of the Health Professions, Weaver continues to advance healthcare policy and education.
We welcome your feedback and comments on this month’s digest at cfhp@atsu.edu.
Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA
Professor and Director
The Center for the Future of the Health Professions
A.T. Still University
Healthcare professional advocacy: Shaping policy and patient care
Advocacy is a crucial component of the healthcare profession, encompassing actions and efforts to represent and promote the interests of patients, healthcare providers, and the broader healthcare system. This dual-purpose approach focuses on improving patient outcomes and advancing the healthcare profession.
Professional organizations and advocacy structure
Healthcare professionals typically engage in advocacy through professional organizations at national and state levels. These organizations unify policy positions and increase public awareness through structured leadership. At the state level, organizations are typically led by a board of trustees and government relations committee that develop legislative agendas. The executive director, serving as a designated lobbyist, manages day-to-day advocacy operations, including committee attendance, testimony coordination, and stakeholder engagement. While many associations also employ additional contracted lobbyists, individual professionals can still advocate independently through available resources and training.1
State-level advocacy issues
At the state level, healthcare professionals face multiple common challenges. The 2024 legislative session highlighted several recurring themes across dental, osteopathic medicine, physician assistant, and physical therapy professions. Key issues include third-party payor reimbursement, Medicaid coverage limitations, regulatory board oversight, and quality of care standards. Scope of practice expansion represents a particularly significant and passionate debate, requiring a formal sunrise review process to analyze potential benefits and drawbacks through data-informed assessment.
Multiple issues at the state level affect healthcare professions. Reviewing some of the bills from the 2024 legislative session affecting the dental, doctor of osteopathy (DO), physician assistant/associate (PA) and physical therapy (PT) professions reveals common issues: third-party payor reimbursement and coverage, Arizona Health Care Cost Containment System (AHCCCS) or Medicaid coverage for specific services, visit limits, and regulatory board issues. Additionally, some of the introduced legislation has raised issues concerning quality of care.
Case study: The Affordable Care Act
The Affordable Care Act (ACA), which was heavily shaped by advocacy from healthcare professionals, stands as a prime example of successful healthcare advocacy in action. Building on the discussed advocacy structures, healthcare professionals across multiple disciplines united to shape this landmark legislation. Physician organizations, nursing associations, and public health experts leveraged their collective expertise to advocate for expanded coverage, insurance exchanges, and patient protections.2
However, it is not necessary to be a member of an association to advocate for the profession. Advocacy training, resources, and information can be shared. An excellent resource is the website azleg.gov, which has bills, bill tracking, summaries, and much more.
Scope of practice expansion affects many healthcare professions and elicits more interest and passion than most other issues. A sunrise review process is a data-informed analysis completed before the state legislature considers a proposal that increases the scope of practice. The result is better information about the proposed legislation’s purported benefits and possible drawbacks.2
The professions seeking scope expansion address the need for this expansion in their applications, which includes but is not limited to, the healthcare workforce shortage, access to care in rural areas, and decrease in costs. Information on education, training, and certification is included to address patient safety concerns. Stakeholder meetings are held prior to the Sunrise Committee hearing to develop consensus.
Challenges and future considerations
While healthcare advocacy plays a vital role in shaping policy and improving patient care, significant challenges persist. Healthcare professionals must balance advocacy efforts with heavy clinical workloads and time constraints. System fragmentation further complicates unified action. However, understanding these challenges helps inform more effective advocacy strategies, emphasizing the need for continued engagement and innovation in healthcare policy development.4
References
1. Gomez EJ. Civil society in global health policy making: a critical review. Glob Health. 2018;14(1):73
2. Kaiser Family Foundation. The Affordable Care Act: A brief summary. 2019. https://www.kff.org/affordable-care-act/fact-sheet/summary-of-the-affordable-care-act/. Accessed January 10, 2025.
3. ARMA News. Advocacy update. March 3, 2003.
4. Levine RJ, Wadden D, Malloy L. Ethical issues in healthcare advocacy: navigating challenges in practice. J Health Ethics. 2017;22(4):340-349.