ACA Personal Statement

Serving individuals in underserved communities takes more than just intellect, it takes character. Filling your brain with the knowledge of various medications is not enough; rather one must empty oneself and become a vessel for compassion. It takes more than a steady hand, but a steadfast heart and a devotion to ethics and the integrity to align with them even when no one is watching. It takes empathy, it takes virtue, and last it takes a passion for cultivating caring and watching it bloom. Contributing to the Nurse Corps mission while nurturing for individuals in underserved communities, I will use these principles as my guiding light in attending to the visible and invisible needs of every patient I serve.

The Affordable Care Act, also known as Obamacare or ACA, was signed into law in March 2010 with the goal to expand insurance coverage to millions of Americans over a period of several years. Since its enactment six years ago, there have been millions of Americans that have gained access to coverage. The most notable of this population would be the disabled, mentally ill, and impoverished. In order to continue to provide quality outcomes for patients, especially patients of vulnerable populations, extra focus must be given to ensure access to healthcare, decreasing disparities, and harvesting improvement in areas such as preventative care, education, and maximizing quality of life. With this influx of people entering the healthcare field, the role of nurses and nurse leaders is also expected to change. Nursing scope of practice and education will be expanded to create an elite healthcare provider. This will include maximizing knowledge in areas of holistic care, education, and preventative care. The incorporation of the ACA into healthcare for vulnerable populations will have several implications for nurses including expanding leadership roles, changing the healthcare delivery model, and providing a broad range of care.

With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting

Moreover, insurers are mandated to cover and provide certain preventive services such as vaccinations without additional charge. The ACA is projected to provide an estimated 32 million uninsured Americans access to health care insurance resulting in more people seeking medical care. As a result of this policy, the demand for nurses is projected to grow at a higher rate (Spetz, 2014). In addition, nurses are confronted with critical changes in health care such as providing efficient and high quality care while keeping the cost affordable. According to Vincent & Reed (2014), the policy plans to enhance the role and expand opportunities in nursing. The law provides funding to expand the number of advance practice nurses and providers. Some experts claim that the growing number of people seeking medical care will not become an issue with the projected nursing workforce due to the many opportunities for expansion as part of the ACA’s provision. In another view, the shortage of Registered Nurses (RN) is projected to intensify as the Baby Boomers age and the need for health care rises in addition to the increasing number of uninsured people that have access to health insurance. Therefore, the increase of patient load due to the extension of health care coverages to millions of previously uninsured people as a result of the ACA will be unmanageable for nurses.

Drafted by congress under the recommendation of president Barack Obama, signed into law on March 23, 2010 by President after long legislative debates, the Affordable Care Act 's main purpose is to provide access to affordable and comprehensive health coverage to millions uninsured Americans who do not have coverage or adequate coverage, those who would be denied coverage under the previous insurance practice either base on pre-existing condition, gender or age, while controlling the cost of health care. (New York Time, October 26, 2014) The purpose of this paper is to provide a comprehensive overview of the Affordable Care Act, examine the nine titles of the law, their effectiveness as well as their impact on the nursing practice today

Although there have been numerous controversies as to whether or not the ACA provides greater benefit or harm, the bottom line is as more have coverage, there will be an increased number of consumers for advanced practice nurses and physicians. Even greater of an impact is the way in which reimbursement has been identified. Under this new law, hospitals and physicians are penalized for readmissions in 30 days for the same diagnosis as manifested by the Centers for Medicare & Medicaid Services (CMS) guidelines. As a result, advance practice nurses are being pushed to provide better outcomes.

The purpose of this paper is to describe the integrated primary care clinical setting under the affordable healthcare act, and the role DNP nurses fulfill as providers of care. Also described will be the professional, regulatory, legal barriers that exist, what DNP APRN nurses need to do to be recognized as DNP nurses with the ability to provide safe, quality, healthcare that improves patient outcomes who deserve to practice autonomously. DNP nurses are prepared to advocate for the patient, create innovative changes in the healthcare delivery system, and provide a holistic approach to healthcare and should be allowed to practice fully to the extent of their education, certification and training.

Recent changes in health insurance coverage and the changing face of the patient population have converged to create a unique healthcare marketplace, rife with opportunities not only for patients but for providers as well. With the passing of the Affordable Health Care Act, 32 million Americans who previously could not afford health care insurance coverage became eligible to purchase affordable healthcare. These patients, therefore, will be able to receive services they have perhaps needed but were previously unable to afford. (Furlow, 2012) The American population includes 75.4 million Baby Boomers, who will be enjoying the retirement years but will be managing chronic health conditions such as COPD, heart disease, and diabetes. (American Hospital Association, 2007) While this increased patient population seeking healthcare services is causing concern for a problematic shortage of physicians, (Raines, 2014) it also heralds new and exciting solutions which include opening doors for midlevel providers, such as Nurse Practitioners and Physician’s Assistants, to succeed as primary healthcare providers in the world of a rapidly changing healthcare system.

In recent years, there have been increased efforts to improve the state of healthcare in the United States. Despite spending much more than any other high-income countries on healthcare each year, the United States is behind many other countries when it comes to overall health status (Squires & Anderson, 2015). There have been several new policies set forth to improve patient outcomes while also cutting costs. In addition to excess spending, there are also concerns regarding the increased demand for healthcare as the baby boomers continue to age (Song & Ferris, 2018). To address these challenges, officials are working toward utilizing advanced practice nurse practitioners (APRNs) to act as healthcare providers for the growing population of

As our healthcare system continues to evolve with the passage and adoption of the Affordable Care Act (Obama Care), new laws and regulations related to medical services reimbursement is also developing. However, disparities continue to exist between medical providers and third-party practitioners such as Advanced Nurse Practitioners(ARNP), leading to a lack of autonomy or independent practice (Woo, & Robinson, 2016). According to (Hain, & Fleck, 2014), many Nurse Practitioners report that payer’s policies have a critical impact in the way they care for patients and negatively reduces their ability practice to their full extent of their clinical expertise and education.

In March 2010 the patient protection affordable care act {PPACA} was passed into legislation for the first time since Medicare was enacted and millions uninsured people was enrolled including all ages, groups and demographics. There was a need for more primary care providers, care coordinators, advance practice nurses and primary care for older adults as millions of insure was enrolled, under the new healthcare paradigm, the advance practice nurse has limitless opportunities to practice.

The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.

Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession

A healthcare partnership inside the community is occurring with private and public facilities working together in a clinic. It is offered to individuals who cannot afford the costs of healthcare, the elderly and immigrants. These different groups come to this location seeking out services they may not find elsewhere inside the area. The way nurses are influencing the kind of care provided, is through serving as a liaison between physicians and patients. During this process, they will work with each client and understand what problems they are facing. As they will communicate any new information to doctors in order to enhance quality. Collectively, nurses will work as a group, in addressing the challenges impacting the clinic and to understand specific difficulties that will effect treatment options. They are sharing these ideas with other stakeholders (such as: the board of directors) in dealing with these issues over the long term. (Lundy, 2003)

Another way of addressing the shortage is to expand the roles and numbers of primary care practitioners (PCNPs) providing primary care services. However, both these options have pros and cons. Even though the Affordable Care Act provided limited funding and new motivations to increase the supply of these clinicians, Congress denied to fund many of these provisions. Also, included in the rejected list of provisions, is the expansion of the PCNP workforce through increased opportunities for interprofessional collaboration and education.