Nurse Practitioners as Primary Care Providers
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
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Often times, the retail clinics are located near the patients’ homes and offer unconventional office hours. Operating every day of the week, patients are usually seen as walk-ins with minimal wait times. Prescriptions can also be immediately filled while they shop for grocery or personal care items in the drug store. Moreover, the cost for the efficient quality care is relatively small compared to that of visiting primary care physicians’ practices. A usual visit to the retail clinic can run between forty to seventy dollars depending on the depth of the service. Convenience care clinics that are purposely designed to be housed in retail stores with high traffic volume have existed to accommodate the public’s quest for convenience and wellness (Hansen-Turton et al., n.d.).
Although the retail clinics are fairly a new concept, the family nurse practitioners strictly adhere to the profession’s scope of practice and established protocols set forth in each retail company. The scope of practice for nurse practitioners however differs from state to state. This lack of consistency creates a hindrance to the fullest potential that the NPs can practice in certain states. Regardless, all NPs in every state are eligible for direct Medicaid reimbursement and Medicare Part B services according to the 1997 Balanced Budget Act (Hansen-Turton et al., n.d.). With or without the physician’s oversight, the FNPs practice safe care within their advanced practice
This raises the capacity for 25 million patient visits in 2017 which significant number in comparison to 2014 numbers of 16 million. The article mentions that the ACA the cost of care in the retail clinic can run 30 to 40 percentage lower than treatments provided by primary care providers and 80 percent lower than ER. It creates savings for the consumer all the way around. The writer states in the healthcare industry, stakeholders are always looking for ways to be innovative and have accessible health care for all. This is proving to be the way ahead, with increasing technology that's being developed and used in the medical arena. The retail clinics can’t help but flourish. In the issue of Health Affairs in 2016, the writer cites that for the 11 low acuity condition that retail clinics treat, the lowered and offset the cost by utilizing resources. For example, it was found that 40 percent of visits were substitute visit for primary care and ER, while the other 60 percent were low acuity visit which presents as a savings of 14 dollars per visit. Consequently, showed cost savings for both the consumer and retail
Rationale: The Affordable Care Act (ACA) has initiated reform throughout the healthcare system and influences the provision of preventive and primary healthcare services. Implementation of the ACA presents an unprecedented opportunity for APRNs (nurse practitioners, certified nurse midwives, and clinical nurse specialists) to take a leadership role in offering primary care and strengthening preventive services. It provides insurance coverage to millions who are currently uninsured and attempts to address areas of the current healthcare system that are in need of reform so that consumer needs for safe care and improved health outcomes are met (Lathrop & Hodnicki, 2014).
Nurse Practitioners (NPs) provide direct care to clients in various settings. Originating in the 1960s, the NP role was designed
The United States is the only remaining industrialized nation without some form of universal access to medical services (Light, 2002). As an industrialized nation, it is shameful to see so many people suffer on various levels due to inadequate access to appropriate health care (Rashford, 2007). Research will show that with equal access to healthcare for everyone in the United States, there would be much more preventative care and therefore the cost for treating chronic diseases could be greatly reduced. The New England Journal of Medicine states that they believe a requirement, in the United States, is broad access to wisely designed programs of health promotion, in which the concept of health promotion is expanded to include a goal of cost reduction. This expanded concept directly addresses the challenge of preventing illness as well as that of reducing health care costs (New England Journal of Medicine, 1993). Did you know that preventable illness makes up for approximately 70% of the burden of illness and the associated costs (New England Journal of Medicine, 1993). Many Americans feel that universal health care is not a role that the government should be involved in however; Medicare, Medicaid, and other federal programs have been shown to improve health for
The role of a family nurse practitioner is a fundamental portion of the future of healthcare. The role is clearly not as understood by other healthcare professionals as needed which results in the disagreement if the role of a family nurse practitioner is even required for primary care. As people are getting older, the need for medical professionals that can provide patient care to our ever growing population increases. The need for the role of family nurse practitioners will grow too. The role of the family nurse practitioner, the ability of the FNP to be able to transition into their role.
The role of the advanced practice nurse (APRN) is evolving with the advancement of health care in the United States. The APRN roles consist of nurse practitioner (NP), certified nurse midwife (CNM), certified nurse anesthetist (CRNA), and clinical nurse specialist (CNS)(Chism, 2016). Scope of practice for APRNs is a critical issue when considering access to care. There are a variety of stakeholders that can benefit from collaboration to promote quality, safe and effective health care for the American population that would decrease the incidence of health care disparities. Some of the stakeholders include APRNs, physicians, insurance companies, legislators and patients. APRNs who have a Doctor of Nursing Practice
Without full practice authority for nurse practitioners, there are a number of disadvantages that will be experienced by both NPs as providers and their patients. The Affordable Care Act and Medicaid expansion has made healthcare more affordable and accessible. While this is a great step to improving the overall health of America, a shortage of provider continues to be a problem. With more people utilizing healthcare services, it is important for NPs to be given full practice authority. The Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorizations Act is one legislations that has partially addressed this issue.
Research data shows that states who have taken the initiative to remove barriers from APRN practice seen an increase in primary care access, and a reduction of medical costs (Florida Association of Nurse Practitioners, 2017). In 2010 the Institute of Medicine (IOM), recommended that in order for ARNP’s to achieve quality output, efficiency, and uniformity of performance, barriers for nurses should be removed, and in 2012 the American Academy of Family Physicians published an article stating there is a need for more primary care providers, and promoting that primary care should be a team effort by physicians and APRN’s, and that both should practice at the full extent of their training, education, and medical skills (Montoya, 2013).
In 2006, the United States allocated 16 percent of the gross domestic product to healthcare (Williams & Torrens, 2008). Healthcare cost is expected to raise $4.7 trillion by 2020 and government is expected to pay for a large share of the total cost (Nordal, 2012). Therefore, health policy is driven by financing a fragmented, decentralized and unplanned system into a more centralized organizational reform with Centers of Medicaid and Medicare having a greater role in the implementation and development of health policy through the federal and state levels as part of their responsibility of these two programs (William & Torrens, 2008). Hospital, physicians and health facilities are operating with tight financial constraints, physician discontent and increasing cost of pharmaceuticals. In addition, to the future of health policy is how it addresses acute or chronic illness model, aging population (i.e. Baby Boomer) and increasing demand the financing of health care will require a preventive model with standardization of
The efforts to improve quality of health care and outcome while bending the curve of health care must be a top national priority. Despite of progressing in reforming the health care market, still not very promising for America’s older adults or population as whole. While more than 90% population is currently insured, cost of Medicare and Medicaid will exhaust large shares of the US economy and federal budget in the next years ahead. Analyses of the employment market and the non-group market has confirmed the rising of premiums and deductibles. With that in mind, it is likely that the America population will encounter with higher rates of illness, disability and early mortality.
Access to preventive health care should not be definable as one of life’s luxuries, yet that is what is has come to be for the approximately “50 million Americans” who have no health insurance (Turka & Caplan, 2010). Clogged emergency rooms and “preventable deaths” are just two of the consequences associated with the lack of health insurance that would provide access to preventive care (Turka & Caplan, 2010). We as a nation are depriving our citizens of one of our most basic needs—being healthy.
(Dade Smith, 2007; Vines, 2011). States that Heart disease, obesity, diabetes, depression, unemployment, alcoholism, are areas that affect rural Australia. Distances, a lack of primary health services, education, cultural variations, communication barriers such as aboriginal and Torres Strait Islander (ATSI) men being nursed by Caucasian female nurses and lack of basic necessities due to low socio-economic factors are primary examples of community/communication needs. Nursing practitioners with the skills to diagnose, treat, prescribe, has the ability to incorporate change to rural communities. With support from professional organisations, the need to increase the NP workforce have created university pathways to empower NP to advance their skills, access advanced technology such as telehealth, access to educational opportunities and share with communities, and individuals.
The retail walk-in clinics are slowly gaining popularity within society. Statistics show that about 40 percent of patients who utilize these services do not
Good health is a significantly valued characteristic of life. However, good health means different things to different people; it is difficult to define. In general, Americans have similar goals for their health. According to the World Health Organization (WHO), “Good health is the capacity to undertake physical effort, to live within one's own potential and carry out tasks with strength and alertness, leaving enough energy for unforeseen emergencies.” For those individuals who are not in good health, it is the healthcare provider’s job to get them back to that point. The elderly tend to require more health services to maintain good health, however, good coverage was not always attainable. In the 1960's, many older Americans found
Health care has been a major topic of debate over the last couple years, especially in the United States. The broken health care system of the U.S. has been ridiculed for being the only developed country that does not have a national health insurance plan that covers each and every citizen (Schneider, 2011). Other developed countries around the world have made examples of themselves by establishing insurance plans that cover every single person. However, these plans have had problems of their own. Even with these small problems, the United States could learn a lot from certain aspects of these countries flourishing health care systems.