Evolving Practice Of Nursing And Patient Care Delivery Models

The Affordable Care Act was passed to provide American’s better access to health insurance coverage. In addition to better access the ACA improved health care quality and lowered health care cost. The ACA reformed health insurance by expanding coverage, holding insurance companies accountable, lowering health care costs, guaranteeing more choices, and enhancing the quality of care. Although some states have not implemented all the benefits of the ACA, most citizens do have access to health insurance. This paper will address some of the general highlights of the ACA, how it impacted healthcare and the nursing practice.

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.

An ACO are groups of healthcare providers who work together to provide cost efficient care for Medicare patients. Nurses will help an ACO by functioning as a care coordinator of Quality Improvement Manager. Care coordinators will have to manage care with doctor offices, hospitals, rehab centers, and home settings, Quality Improvement Managers will focus on analyzing data and promoting evidence based practices.

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

The Accountable Care Organization (ACO) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients (McCarty, B., 2016). For example, Medicare Shared Savings Program was created by The Center for Medicare & Medicaid Services to monitor and establish that all ACO’s are meeting the quality performance benchmarks and reduce Medicare spending by certain percentages (H., 2017). The growth of ACO’s from 2011 to 2016 is astonishing, in 2011 there was 64 ACO’s and by 2016 they have risen to 838 in the U.S. (H., 2017).

The Affordable Care Act created a new approach to care which is called the Accountable Care Organization. ACO is a system of doctors and hospitals that share a financial and medical responsibilities. If the ACO is successful in meeting quality and cost savings targets, these organizations qualify for financial incentives or shared saving from Medicare programs. The goal of the ACO is to coordinate

​Kaiser Health News recently published an article on a new trend in healthcare. This trend introduces the Accountable Care Organization (ACO). The Centers for Medicare and Medicaid services defines it as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (“Accountable Care Organization,” 2015). According to the Affordable Care Act (ACA), the goal of the ACO is to be able to share health cost-savings with providers who are able to save money by eliminating unnecessary procedures and reduce health costs while increasing quality of care. ACOs make health professionals become more accountable in maintaining good-quality, coordinated healthcare for a patient through a value-based system that is evaluated through a number of criteria and benchmarks (Ronai, 2011).

One common theme that has resurfaced throughout the entire Obama administration and has created a great deal of focus and debate is health care reform. The Patient Protection and Affordable Care Act (PPACA) which was introduced by Obama in 2010 creates a new structure of health care. It transforms health care from “late-stage, high intensity, illness focused, tertiary, interventional health service to a much stronger value driven focus on achieving the highest levels of health” (Porter-O’Grady, 2014, p. 65). Through this act, legislation has been created that regulates the way hospitals and physicians are reimbursed, which is built on evidenced-based, quality health care outcomes that are cost effective without infringing upon patient satisfaction. At the heart of this debate is the impact on nursing care, for nursing is the largest health care professional as well as the largest component of health care costs. Any change in the health care reimbursement will greatly affect the nursing practice (Buerhaus, 2010). In order to fully understand the impact of this health care reform, one must understand that health care reform is not a new concept. Health care reform has been transforming since the 1800s.

In 2010, the Patient Protection and Affordable Care Act, or PPACA gave many Americans the opportunity to have health care coverage that previously may have not been available to them. The reform is primarily aimed at decreasing the number of uninsured and underinsured Americans. The landscape of health care is changing and nursing is evolving alongside it. This health care overhaul gives nurses a vital role in leading the reform revolution. With more than three million strong, nursing is the biggest sector of the nation’s health care labor

The American Nurses Association (ANA) is a full-service professional organization that symbolizes the interests of registered nurses through its constituent and state nurses associations. The ANA implements the nursing profession by raising high standards of nursing practice, honoring the rights of nurses in the work field, promoting a positive and realistic view of nursing, and by pushing the Congress and regulatory agencies on health care issues affecting nurses and the public. Their mission statement is, “Nurses advancing our profession to improve health for all.” Some of ANA’s main focuses are reformation of the health care system so that it delivers primary health care in the communities, growing roles for

“The ACA outlines some new health care arrangements, and with these structures will come new opportunities for new roles. Nurses have the opportunity to play a central role in transforming the health care system to create a more accessible, high-quality, and value-driven environment for patients. If the system is to capitalize on this opportunity, however, the

The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor

This paper seeks to expand upon the 2010 Institute of Medicine’s report on the future of nursing, leading change, advancing health and illustrating its impact on nursing education, practice and leadership. There is an ongoing transformation in the healthcare system necessitated by the need to achieve a patient centered care in the community, public, and primary care settings in contrast to previous times. Nurses occupying vital roles in the healthcare system, need improvements in the areas mentioned above to

Healthcare Reform has been and still is a highly debated controversial political issue in this country. It has been a hot topic of past presidential campaigns, with many proposed solutions, none of which were enacted upon by Congress. The Affordable Care Act (ACA) was passed in 2010. This law or Obamacare, as it is commonly called, was designed to cover the 48 million Americans, including about 1 million in New Jersey who did not have health insurance. It is envisioned to provide seamless, affordable, quality care that is accessible to all. Great emphasis will be placed on transforming our current “sick care” hospital system into a community “health care” system of prevention and health promotion. This paper discusses the evolving and future roles of nurses under the new system. It also examines the proposals of a joint committee made up of members of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), as an initiative to help nurses in their new leadership roles to a healthier nation.

There are over three million nursing professional in United States and they make the largest segment of nation’s health care workforce. Nurses can play a vital role in helping to realize the objectives set forth in the 2010 affordable act, legislation that represents the broadest health care overhaul since the 1965 creation of Medicare and Medicaid program (IOM 2010). Due to the restricting barriers nurses were not able to respond effectively to the changing health care systems. In 2008, The