Nurse Managed Health Centers Essay

There is a growing trend where physicians are choosing different specialties instead of choosing primary care, primarily due to the low reimbursement rate in primary care. According to Iglehart (2014),” the Association of American Medical Colleges (AAMC) still projects a shortage of 130,000 physicians by 2025, split almost equally between primary and specialty care” (para. 1). With this decline comes an answer, an increase in the number of nurse practitioners providing patient care, reported 154,00 in 2012 and growing every year (Iglehart, 2014). This increase in nurse practitioners’ helps fill that gap, allow greater health care access to the community, especially special populations. By gaining access to healthcare were a nurse practitioner is the provider not only with the special population have high quality affordable health care, a trusting long lasting relationship will develop. This relationship will break the barriers of; lack of trust, lack of health care education and discrimination. Nursing is a trusted profession that provides education and care that no other health care professional

There is an imbalance between primary and specialty care services in the U.S. health care delivery system.

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

Nurse Practitioners (NPs) play a key role in long term health care by ensuring provision of holistic healthcare services particularly in remote areas and in those areas that have few physicians. Currently, there is a concern where there is a shortage of physicians in nursing homes and in other critical health care services questioning the care being provided (Colwill, Cultice, & Kruse, 2008). Due to population growth,

Currently, there is still a large shortage of primary care practitioners in the United States. The margin between available providers and those in need continues to grow. Many people without proper access to care have to delay seeking help for what ails them ("Health Wanted," 2012). Glicken & Miller (2013) state that approximately 16,000 primary care providers would be necessary to meet the existing demand. Rural communities would represent the area of greatest need followed closely by low-income urban areas. The number of underserved individuals is estimated to have reached fifty-seven million. This demand will only increase, as 52,000 primary care providers are expected to be needed by the year 2025 (Glicken & Miller, 2013, p.1883-1889).

Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different

The underserved populations have increased exponentially. The Rural Policy Research Institute (2009) defines the medically underserved as, “the ratio of primary care physicians per 1,000 population, the infant mortality rate, the percent of the population with incomes below the poverty level, and the percent of the population age 65 and over.” By that definition, over half the state is considered to be an underserved population. With the demand and needs of the state, it is no surprise that the FNP has become a more utilized provider of healthcare is many settings. There has also been a recent emergence of nurse-managed health centers or (NMHCs), as a form of primary care delivery. According to Espirat and Debisette (2012), NMHCs reduce Medicaid costs, are a great Segway to community outreach and provide quality primary prevention.

The decline in hospital capacity was accompanied by a rise in staffing. Full-time equivalent personnel rose (Malagi & Kamath, 2016). Most of the additional personnel in hospitals are not focused on patient care but management or administration purposes. The American Hospital Association data shows that outpatient department visits have risen per 1,000 persons indicating that capacity for ambulatory services has risen overtime. Emergency departments have reduced with a larger percentage of closures being in rural areas. Compared to hospitals, physicians have continued to increase. Specialists have increased except for radiologists and general surgeons. There is, however, an uneven distribution of physicians between rural and urban areas. There is an estimated shortage of 3,000 physicians in nonmetropolitan areas. In addition to an increase in physicians, there are new forms of acute-care facilities. There are relatively new facilities that have been accredited. Ambulatory surgery centers have, for instance, risen (Best et al.,

Americans will have insurance coverage. The US has an unequal distribution of the primary care, thus; the rural areas have been left with only few physicians. Many physicians prefer practicing in urban areas because of the lucrative advantage, better technology or demographic preference. Many sources including Green et al, of Anita Phigpen Perry School of nursing confirms that the reason for the shortage of physicians in the rural areas is due to the tendency of people in the rural areas being poorer, sicker and older . This segment of people tends to be uninsured, and physicians are attracted to urban and suburb areas where revenues are. Today with the ACA policies, people in the underserved area have better access to physicians, although the shortage persists. The US Department of Health and Human Services, states that to help strengthen access to the primary care workforce, the Affordable Care Act invests in health work force training, including: a $ 1.5 billion investment in National Health Service Corps Scholarship and loan repayment programs and $ 230 million over five years to primarily train medical residents in community-bases. However, do we have enough experts?

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

Even after half a decade there remains a shortage in primary care providers with only a reported one forth of medical school graduates seeking residencies in family practice, pediatrics, and obstetrics/gynecology. The FNP is a qualified clinically competent healthcare member that can fill this void in primary care in this cost-sensitive society. Despite barriers like the lack of third-party reimbursement, prescriptive authority, and hospital admission privileges the projected employment

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.

The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.

The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.

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