Home Care Proposal

Many nursing homes assume in error that if a patient has stopped making progress towards recovery then Medicare coverage should end. In fact, if the patient needs continued skilled care simply to maintain his or her status then the care should be provided and is covered by Medicare.In fact, patients often receive an array of treatments that don 't need to be carried out by a skilled nurse but that may, in combination, require skilled supervision.Even in cases where the SNF initially treats the patient as a Medicare recipient, after two or more weeks, often, the SNF will determine that the patient no longer needs a skilled level of care and will

been restricted on what they can and can’t do including signing certain documents and orders they can prescribe. With the Affordable Care Act the demand for primary care providers is growing (Gadbois, Miller, Tyler, & Intrator, 2015). This means that the need for APRNs is rising and the need change is approaching. In the primary care setting, there is a variety of medical staff working including medical assistance, LPNs, and RNs. This can become more for the APRN when delegating medication administration. When the APRN cannot delegate medication administration the quality of patient care is sacrificed and is not productive in providing care to the patients.

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician

Currently, the Affordable Care Act establishes nurse practitioners as providers whom are eligible providers in ACOs; however, the current Medicare Shared Savings program statute prevents beneficiaries of Medicare, who are receiving primary care service from a nurse practitioner, from being assigned to Accountable Care Organizations inside the program (AANP, 2015). The American Association of Nurse Practitioners (2015) also claim the exclusion of nurse practitioners must be repealed if ACOs want to develop further as models of practice, which improve cost effectiveness, patient access and quality.

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

There is an increasing demand for nurse practitioners, which makes this a crucial period in the development of their practice and profession. Nurse practitioners must face increased opportunity and continuing opposition towards independent practice all while defining their role in health care delivery and establishing their connections. The practice of nurse practitioners still varies widely across the states. These inconsistencies make it difficult for nurse practitioners as well as patients when practice

Currently, the law requires NPs to obtain physician approval during care of a patient that include managing patient health, conducting assessments, ordering/prescribing medications, lab tests, and medical devices with the supervision of a physician or surgeon. The requirement makes it challenging for NPs to provide care and limits the accessibility of care

The current US Health Care delivery system Affordable Care Act (Obamacare), allows its citizens access to healthcare by NPs who practice autonomously providing healthcare to underserved rural populations, and in clinical settings, (McClelland, 2014; Stanley, 2011). The term autonomously and under prescriptive authority allows the NP establish realistic outcome measures, prescribe medications to provide secure, real, patient centered, appropriate, effective and reasonable care without a physician. Tiplady and Cook, (2015) stated that “outcome-based practice focuses on what an individual wants to achieve, and not only what the service wants to achieve (p. 406). For example the NP and the San Rafael patient in their relationship establish

The Affordable Care Act provides a lump sum, up to 1.1 million dollars, as a grant to increase home visitations and care of patients by home health nurses and social workers to high-risk expectant mothers. This grant is to help reduce the mortality rate and improve outcomes for mothers and babies. Affordable Care Act also provides grants to run community-based clinics championed by advanced practice nurse practitioners that have been proved to be cost-effective using nurse practitioner in routine office visits. Many HMO’s prefer patients seeing nurse practitioners expect in

In 2013, Dorota Slawa Mankowska et al, worked on real study for a home care company that present the care for the at patients in their homes by staff members. They developed the mathematical model that aim to optimizing economical service cost and take care about individual qualifications of the staff, time preferences of patients, number of the staff required to this patient and certain time of patient’s drugs. This model has been able to achieve low average waiting times for patients, low traveling cost for caregivers, a fair distribution of inevitable tardiness, and service hundred patients in acceptable runtime.

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

The goal of home health care is to offer cost effective patient-centered care for patients recuperating from an acute condition, managing a chronic condition, rehabilitative episode, or supporting a severe mental illness. Over the years the United States has fell in and out of favor with utilizing home health care and the public polices directly reflects the sentiments of the era. Are we returning to the roots of home health care in the United States? With the passage of the Affordable Care Act (ACA) and inclusion of Triple Aim, the pendulum is once again swaying toward including home health providers as a means of optimizing health care for Americans. Triple Aim is a concept-developed by the Institute for Healthcare Improvement (IHI) that focuses on “improving the patient experience of care, improving the health of populations, and reducing the per capita cost of heath care.” (IHI triple aim) Using home health will help achieve the goal of Triple Aim. Home health will work with patients by assessing the right care at the right time while closely monitoring patient’s status to analyze where on the continuum of health the patient will receive the appropriate level of care