The Patient Protection And Affordable Care Act

1777 Words Aug 7th, 2016 8 Pages
Nursing Practice continues to evolve in order to adapt to perpetual revamping and reshaping of the healthcare system. The Patient Protection and Affordable Care Act (PPACA) calls for a dramatic and rapid metamorphosis of patient care delivery models in order to provide cost effective, safe, efficient, and high quality care to every American (Cherry & Jacob, 2016).
As a result, healthcare is shifting from management in an acute care setting toward prevention and wellness in a community-based primary care setting (Dickerson, 2014). This has created an enormous opportunity for the expansion and emergence of new roles for Advanced Practice Nurses (APRNs) and registered nurses (RNs) alike.
Healthcare Reform is opening doors “to a more central
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Similar to ACOs, PCMHs provide patient care that is comprehensive, patient-centered, coordinated, accessible, safe and high quality (Agency for Healthcare Research and Quality [AHRQ], n.d.). In this model patients are assessed in a holistic approach (ANA, 2010). Care is coordinated by PCPs who arrange for appropriate “team members” to provide care for patient specific needs, allowing for continuity of care and reducing duplicate medications and labs (ANA, 2010). Team members support PCPs, are state-designated or community–based teams, and includes nurses, pharmacist, educators, care coordinators, dieticians, social workers, specialized physicians, integrative medicine providers, chiropractors, PAs, and behavior health providers (ANA, 2010; Cherry & Jacobs, 2016). PCMHs use best evidence-based practices to coordinate and integrate care, improve quality of care, and incorporate health promotion and prevention services within the community (ANA, 2010). Reimbursement is through an integration of pay-per-performance, fee-for-service, and patient care coordination reimbursement (Adams et al., 2013).
NMHCs are comprehensive primary care and wellness centers managed by APRNs, who provide care to all individuals regardless of their ability to pay, and are often found in medically underserved areas (Wilson, Whitaker, & Whitford, 2012). PCPs manage chronic conditions, promote wellness and prevention, and coordinate care to other specialists if appropriate.
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