Healthcare Delivery Models and Nursing Practice: Affordable Care Act
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse's role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Healthcare Delivery Models and Nursing Practice
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Question 1
The Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA), became law in 2010. Former President Barrack Obama sanctioned the act, hence the nickname Obamacare. The policy aimed to promote insurance coverage for all Americans by lowering the cost of health insurance. The law has provision for subsidies for low-income individuals to ensure that everyone is covered. The ACA protects vulnerable populations from insurance companies that deny coverage to people with preexisting conditions or raise costs. Initially, the law required everyone to be protected or face penalties. The law also required organizations with more than two hundred employees to provide insurance coverage.
The ACA has had a significant impact on the overall healthcare delivery system. It provides an opportunity for health care workers to shape the delivery of services. The nurses are keener in their roles as the law requires that hospital payment be value-based. The ACA introduced programs to reward or penalize actions by healthcare providers. Some of the initiatives are the Hospital-Acquired Condition Reduction Program, the Hospital Readmission Reduction Program, and the Hospital Value-Based Purchasing Program (Lee & Porell, 2020). The ACA focuses on results, putting more pressure on nurses to perform. Providing adequate care increases the demand for advanced education to practice. Advanced practice nurses (APNs) and nurse practitioners (NPs) require advanced education and, as a result, contribute to better results than regular nurses.
When the government introduced the ACA, more people could access health care. The increased demand for healthcare services increased the need for more nurses. Although hospitals recruited more nurses, there is still a nursing shortage. The inadequate nurse-to-patient ratio has resulted in long working hours for nurses, resulting in fatigue, which leads to poor patient care, hence poor outcomes.
Question 2
Quality measures are tools used to quantify the healthcare processes, systems, and outcomes linked to offering quality health care. The indicators can also help quantify healthcare goals such as prudent, logical, equitable, practical, and patient-centered care. Pay for performance refers to payment programs based on the employee's performance. The employee receives incentives and rewards for achieving goals and penalties for poor outcomes. The programs used to assess value-based care aim to determine how many patients acquired another condition while in the hospital or how many people were readmitted after discharge. This approach improves patient outcomes because the practitioners are motivated to offer high-quality services that yield desirable results. However, patients with complicated disorders whose prognosis is likely to be poor may risk being dumped by healthcare providers. The physicians and nurses may avoid treating them for fear of being penalized.
Quality measures and pay-for-performance programs affect nursing practice in various ways. This model may help to increase the nurses' effectiveness and efficiency at their jobs. For instance, they ensure that patients receive all the recommended medication, provide clear discharge instructions, and follow the right wound care protocols for surgical patients. However, the pay for performance approach may not apply in some situations. Healthcare providers who care for low-income clients may not perform well on these models (Peckham & Wallace, 2018). Poor patients can barely a...