Health Care Delivery Models And Nursing Practice Essay Research

Health Care Delivery Models And Nursing Practice Essay Research

Affordable Care Act (ACA) and Nursing Practice

Health care in the U.S and the rest of the world has dramatically evolved over time. The ever-emerging changes in health have altered critical practices in the healthcare landscape. This paper focuses on how the Affordable Care Act (ACA), alternatively called Patient Protection and Affordable Care Act, or Obamacare, transformed U.S healthcare systems. This one of the highly transformative health laws that was crafted to achieve three mainstream goals, which entails: making health coverage more affordable to higher number of U. S citizens: expansion the Medicaid program to increase coverage amongst all adult population: preserving and sustaining both employer or job-based health coverage and Medicare: and enhancing state control/regulation of insurance market (Cleveland, Motter, Smith, 2019)Health Care Delivery Models And Nursing Practice Essay Research. Thus, the overall purpose involved increasing the accessibility and affordability of healthcare services via innovative approaches.

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This healthcare act is a deliberate effort to restructure the U.S healthcare system from a multifaceted approach. ACA, which was signed into law on March 23, 2010, continues to be the most radical healthcare legislation in the U.S since the inception of Medicare and Medicaid programs. This law creates a new direction for the U.S health care system with greater emphasis on preventive services and primary care. This paper will specifically focus on the ACA’s influence on nursing practice and discuss how quality measures and pay-for-performance (P4P) influence patient outcomes within the context of nursing roles and expectations. It will also explore professional nursing leadership and management roles in delivering safe and quality care in various settings, as well as emerging trends in nursing practice and roles.

Impact of ACA on Nursing Practice, Roles and Responsibilities

ACA has a far-reaching implication on nursing practice. The ACA empowers nurses to adopt innovation, enhance care coordination, and adopt transformational leadership in delivering care that is quality, accessible and affordable (Cleveland, Motter, Smith, 2019). The ACA seeks to realign and expands nurses’ scope of practice, roles and responsibilities, as contemplated in this act. Nurses naturally respond to changes in regulation and financing of healthcare with innovation and professional responsibility (Cleveland, Motter, Smith, 2019)Health Care Delivery Models And Nursing Practice Essay Research. According to Cleveland, Motter and Smith (2019), the act made nurses more proactive in addressing financial healthcare concerns via integrated programs and processes in collaboration with legislators, policymakers, and healthcare administrators as they seek to bridge the gaps between funding the insurance plan imbalances /disruptions, Medicare Trust, and other health-associated costs. Although the quality of care, availability of resources and value in health expenditures, aren’t new concepts to the nursing practice, the ACA confers a legislative approach that connects such concepts to payment or reimbursement initiatives. Thus, nurses are responsible for shaping healthcare due to their team approach, closeness to the bedside, and understanding of patient care within the community and the hospital settings.

Nurses enjoy a privileged healthcare perspective because they not only help patients but also experience how patients meet daily healthcare costs. Thus, nurses are well-positioned to provide a unique, expert contribution from bedside and general perspective healthcare settings. The ACA expands the roles and responsibilities of nurses because they constitute human health resources who are at a vantage point of implementing ACA-related policy directives. Besides this, the ACA places a greater emphasis on outcomes. Thus, the nursing practice should be able to provide effective care. With the increased need for preventive care, the dynamic of nursing practice is slightly altered, with many nurses being expected to deliver preventive care services. The implementation of the ACA provides nurses with responsibilities, functions and roles that not only expand nursing practice but also compel nurses to be more innovative and transformative in enhancing access and quality of healthcare services Health Care Delivery Models And Nursing Practice Essay Research.

How quality measures and P4P affect patient outcomes

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The adoption of ACA appears to stimulate conversation and implementation of alternative payment approaches such as the pay-for-performance (P4P) model. The P4P model seeks to provide financial incentives to providers such as physicians and hospitals to improve quality and efficiency (Fainman & Kucukyazici, 2020). Typically, incentives are paid in addition to FFS compensation when the healthcare provider meets or exceeds specified pre-established performance metrics. Some models penalize providers when some predetermined performance standards are not achieved, such as in the case of hospital readmissions and medication errors. More often, the insurance company, Medicare or Medicaid, use claims or administrative data to assess provider performance based on four metrics, i.e., process, outcome, patient satisfaction and structures metrics (Weismann, Ganske & Delgado, 2020)Health Care Delivery Models And Nursing Practice Essay Research. These dimensions affect nursing practice, expectations and responsibilities of the nursing role. With P4P, nursing practice has to focus on processes, outcome, patient satisfaction and structure metrics, as metrics part of ACA and P4P. Focusing on processes, patient outcomes, patient satisfaction, and structures would help optimize health outcomes and improve quality. Thus, the roles of nurses should be geared towards improving the process, patient outcomes, patient satisfaction and organizational structures, such as enhancing nurse/physician-patient ratios in light of ACA.

Professional nursing leadership and management roles arising from emerging trends and in the promotion of patient safety and quality care

With the ACA, Professional nursing practitioners have expanded leadership and management roles in enhancing patient safety and quality. Following ACA integration into the U.S healthcare system, quality has been tied to reimbursements, evidenced by an increased emphasis on the P4P model. With an increasing level of nursing education, training and removing barriers to the full scope of nursing practice, there is a need for nursing leaders and managers to advance quality and safety care initiatives across various healthcare delivery settings. The P4P model seeks to improve healthcare quality and safety through financial incentives. By improving adherence to best practices through providing a financial incentive for health practitioners, nursing managers and leaders would need to focus more on approaches to enhancing the quality of care, safety and clinical outcomes. For instance, using proven, evidence-based clinical guidelines would help deliver quality care with optimized outcomes Health Care Delivery Models And Nursing Practice Essay Research.

Research Emerging Trends

With the implementation of the ACA and emerging healthcare challenges, the nursing practice and nursing roles will continue to grow and transform. First, nursing roles will likely increase the focus on primary care and preventive health in the future. Secondly, the need for quality and safer care will continue to grow. Nurses will be expected to deliver effective healthcare marked by high quality and safety standards.

References

Cleveland, K.A., Motter, T., Smith, Y., (May 31, 2019) “Affordable Care: Harnessing the Power of Nurses” OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 2, Manuscript 2.

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.

Fainman, E. Z., & Kucukyazici, B. (2020). Design of financial incentives and payment schemes in healthcare systems: A review. Socio-Economic Planning Sciences, 72, 100901.

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.

Weismann, M., Ganske, S., & Delgado, O. (2020). Cleveland Clinic Florida “pay-for performance” reimbursement: why the best care does not always make the happiest patients. The CASE Journal Health Care Delivery Models And Nursing Practice Essay Research.

Affordable Care Act (ACA) and Nursing Practice

Health care in the U.S and the rest of the world has dramatically evolved over time. The ever-emerging changes in health have altered critical practices in the healthcare landscape. This paper focuses on how the Affordable Care Act (ACA), alternatively called Patient Protection and Affordable Care Act, or Obamacare, transformed U.S healthcare systems. This one of the highly transformative health laws that was crafted to achieve three mainstream goals, which entails: making health coverage more affordable to higher number of U. S citizens: expansion the Medicaid program to increase coverage amongst all adult population: preserving and sustaining both employer or job-based health coverage and Medicare: and enhancing state control/regulation of insurance market (Cleveland, Motter, Smith, 2019). Thus, the overall purpose involved increasing the accessibility and affordability of healthcare services via innovative approaches.

Impact of ACA on Nursing Practice, Roles and Responsibilities

ACA has a far-reaching implication on nursing practice. The ACA empowers nurses to adopt innovation, enhance care coordination, and adopt transformational leadership in delivering care that is quality, accessible and affordable (Cleveland, Motter, Smith, 2019). The ACA seeks to realign and expands nurses’ scope of practice, roles and responsibilities, as contemplated in this act. Nurses naturally respond to changes in regulation and financing of healthcare with innovation and professional responsibility (Cleveland, Motter, Smith, 2019). According to Cleveland, Motter and Smith (2019), the act made nurses more proactive in addressing financial healthcare concerns via integrated programs and processes in collaboration with legislators, policymakers, and healthcare administrators as they seek to bridge the gaps between funding the insurance plan imbalances /disruptions, Medicare Trust, and other health-associated costs. Although the quality of care, availability of resources and value in health expenditures, aren’t new concepts to the nursing practice, the ACA confers a legislative approach that connects such concepts to payment or reimbursement initiatives. Thus, nurses are responsible for shaping healthcare due to their team approach, closeness to the bedside, and understanding of patient care within the community and the hospital settings Health Care Delivery Models And Nursing Practice Essay Research.

How quality measures and P4P affect patient outcomes

ACA seeks to optimize health outcomes. Since the inception of the ACA, the law has transformed the U.S health care system by expanding health coverage to millions Of Americans and saving thousands of lives. This milestone has been achieved by adopting quality interventions for patients with preexisting conditions and eliminating patient cost-sharing for high-value preventive services. The act strives to promote quality approaches to healthcare, such as incentivizing appropriate management of patients such as in making correct diagnoses and enhancing seamless communication between different levels of providers and specialists. Besides this, increased collaboration and interprofessional working amongst physicians, specialists and nurses would offer the best quality follow-up care after lengthy hospital stays. Despite the high healthcare costs in U. S, access, efficiency, quality, equity, and health outcomes are relatively poor compared to other developed counties (Dickman, Himmelstein & Woolhandler, 2017: Papanicolas, Woskie & Jha, 2018)Health Care Delivery Models And Nursing Practice Essay Research. The U.S common payment structure is the fee-for-service model (FFS), whose payments are advanced to providers based on the quantity and complexity of services provided, but this system of payment lacks elements of accountability for quality and efficiency. The adoption of ACA appears to stimulate conversation and implementation of alternative payment approaches such as the pay-for-performance (P4P) model. The P4P model seeks to provide financial incentives to providers such as physicians and hospitals to improve quality and efficiency (Fainman & Kucukyazici, 2020). Typically, incentives are paid in addition to FFS compensation when the healthcare provider meets or exceeds specified pre-established performance metrics. Some models penalize providers when some predetermined performance standards are not achieved, such as in the case of hospital readmissions and medication errors. More often, the insurance company, Medicare or Medicaid, use claims or administrative data to assess provider performance based on four metrics, i.e., process, outcome, patient satisfaction and structures metrics (Weismann, Ganske & Delgado, 2020). These dimensions affect nursing practice, expectations and responsibilities of the nursing role. With P4P, nursing practice has to focus on processes, outcome, patient satisfaction and structure metrics, as metrics part of ACA and P4P. Focusing on processes, patient outcomes, patient satisfaction, and structures would help optimize health outcomes and improve quality. Thus, the roles of nurses should be geared towards improving the process, patient outcomes, patient satisfaction and organizational structures, such as enhancing nurse/physician-patient ratios in light of ACA.

Professional nursing leadership and management roles arising from emerging trends and in the promotion of patient safety and quality care Health Care Delivery Models And Nursing Practice Essay Research

Research Emerging Trends

References

Cleveland, K.A., Motter, T., Smith, Y., (May 31, 2019) “Affordable Care: Harnessing the Power of Nurses” OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 2, Manuscript 2.

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.

Fainman, E. Z., & Kucukyazici, B. (2020). Design of financial incentives and payment schemes in healthcare systems: A review. Socio-Economic Planning Sciences, 72, 100901.

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.

Affordable Care Act (ACA) and Nursing Practice

Health care in the U.S and the rest of the world has dramatically evolved over time. The ever-emerging changes in health have altered critical practices in the healthcare landscape. This paper focuses on how the Affordable Care Act (ACA), alternatively called Obamacare, transformed U.S healthcare systems. This one of the highly transformative health laws that was crafted to achieve three mainstream goals, which entail: making health coverage more affordable to a higher number of U. S citizens: expanding the Medicaid program to increase coverage amongst all adult populations: preserving and sustaining employers or work-based health and Medicare coverage: and enhancing state control/regulation of insurance market (Cleveland, Motter, Smith, 2019)Health Care Delivery Models And Nursing Practice Essay Research. Thus, the overall purpose involved increasing the accessibility and affordability of healthcare services via innovative approaches.

This healthcare act is a deliberate effort to restructure the U.S healthcare system from a multifaceted approach. ACA, which was signed into law on March 23, 2010, continues to be the most radical healthcare legislation in the U.S since the inception of Medicare and Medicaid programs. This law creates a renewed orientation for the U.S health care system with greater emphasis on preventive medicine, which is anchored on the primary care framework. This paper will specifically focus on the ACA’s influence on nursing practice and discuss how quality measures and pay-for-performance (P4P) influence patient outcomes within the context of nursing roles and expectations. It will also explore professional nursing leadership and management roles in delivering safe and quality care in various settings, as well as emerging trends in nursing practice and roles.

Impact of ACA on Nursing Practice, Roles and Responsibilities

ACA has a far-reaching implication on nursing practice. The ACA empowers nurses to adopt innovation, enhance care coordination, and adopt transformational leadership in delivering care that is quality, accessible and affordable (Cleveland, Motter, Smith, 2019). The ACA seeks to realign and expands nurses’ scope of practice, roles and responsibilities, as contemplated in this act. Nurses naturally respond to regulatory transformation and financing of healthcare with innovation, professional responsibilities and roles (Cleveland, Motter, Smith, 2019)Health Care Delivery Models And Nursing Practice Essay Research. According to Cleveland, Motter and Smith (2019), the act made nurses more proactive in addressing financial healthcare concerns via integrated programs and processes in collaboration with legislators, policymakers, and healthcare administrators as they seek to bridge the gaps between funding the insurance plan imbalances /disruptions, Medicare Trust, and other health-associated costs. Although the quality of care, availability of resources and value in health expenditures, aren’t new concepts to the nursing practice, the ACA confers a legislative approach that connects such concepts to payment or reimbursement initiatives. Thus, nurses are responsible for shaping healthcare due to their teamwork, practical experience and knowledge about bedside care, and understanding of client care within the communities and the hospital settings.

Nurses enjoy a privileged healthcare perspective because they help patients and experience how patients meet daily healthcare costs. Thus, nurses are well-positioned to provide a unique, expert contribution from the bedside and general perspectives in healthcare settings. The ACA expands the roles and responsibilities of nurses because they constitute human health resources who are at a vantage point of implementing ACA-related policy directives. Besides this, the ACA places a greater emphasis on outcomes. Thus, the nursing practice should be able to provide effective care. With the increased need for preventive care, the dynamic of nursing practice is slightly altered, with many nurses being expected to deliver preventive care services. The implementation of the ACA provides nurses with responsibilities, functions and roles that not only expand nursing practice but also compel nurses to be more innovative and transformative in enhancing access and quality of healthcare services Health Care Delivery Models And Nursing Practice Essay Research.

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How quality measures and P4P affect patient outcomes

ACA seeks to optimize health outcomes. Since the inception of the ACA, the law has rebuilt and renewed the U.S healthcare system by increasing health coverage for millions of U.S citizens and helping thousands of people in accessing crucial healthcare services for managing infections and non-communicable diseases. This milestone has been achieved by adopting quality interventions for patients with preexisting conditions. This has also been done by eliminating patient cost-sharing for high-value preventive health services. The act strives to promote quality approaches to healthcare, such as incentivizing appropriate management of patients such as in making correct diagnoses and enhancing seamless communication between different levels of providers and specialists. Besides this, increased collaboration and interprofessional working amongst physicians, specialists and nurses would offer the best quality follow-up care after lengthy hospital stays. Despite the high healthcare costs in U. S, access, efficiency, quality, equity, and health outcomes are relatively poor compared to other developed counties (Dickman, Himmelstein & Woolhandler, 2017: Papanicolas, Woskie & Jha, 2018)Health Care Delivery Models And Nursing Practice Essay Research. The U.S common payment structure is the fee-for-service model (FFS), whose payments are advanced to providers based on the quantity and complexity of services provided, but this system of payment lacks elements of accountability for quality and efficiency.

The adoption of ACA appears to stimulate conversation and implementation of alternative payment approaches such as the pay-for-performance (P4P) model. The P4P model seeks to provide financial incentives to providers such as physicians and hospitals to improve quality and efficiency (Fainman & Kucukyazici, 2020). Typically, incentives are paid in addition to FFS compensation when the healthcare provider meets or exceeds specified pre-established performance metrics. Some models penalize providers when some predetermined performance standards are not achieved, such as in the case of hospital readmissions and medication errors. More often, the insurance company, Medicare or Medicaid, use claims or administrative data to assess provider performance based on four metrics, i.e., process, outcome, patient satisfaction and structures metrics (Weismann, Ganske & Delgado, 2020). These dimensions affect nursing practice, expectations and responsibilities of the nursing role. With P4P, nursing practice has to focus on processes, outcome, patient satisfaction and structure metrics, as metrics part of ACA and P4P. Focusing on processes, patient outcomes, patient satisfaction, and structures would help optimize health outcomes and improve quality. Thus, the roles of nurses should be geared towards improving the process, patient outcomes, patient satisfaction and organizational structures, such as enhancing nurse/physician-patient ratios in light of ACA Health Care Delivery Models And Nursing Practice Essay Research.

Professional nursing leadership and management roles arising from emerging trends and in the promotion of patient safety and quality care

With the ACA, Professional nursing practitioners have expanded leadership and management roles in enhancing patient safety and quality. Following ACA integration into the U.S healthcare system, quality has been tied to reimbursements, evidenced by an increased emphasis on the P4P model. With an increasing level of nursing education, training and eradicating barriers to the entire scope of nursing practice, there is a need for nursing leaders and managers to advance quality and safety care initiatives across various healthcare delivery settings. The P4P model seeks to improve healthcare quality and safety through financial incentives. By improving the adoption of best practices through offering a financial incentive for health providers, nursing managers and leaders would need to focus more on approaches to enhancing the quality of care, safety and clinical outcomes. For instance, using proven, evidence-based clinical guidelines would help deliver quality care with optimized outcomes.

Research Emerging Trends

References

Cleveland, K.A., Motter, T., Smith, Y., (May 31, 2019) “Affordable Care: Harnessing the Power of Nurses” OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 2, Manuscript 2.

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.

Fainman, E. Z., & Kucukyazici, B. (2020). Design of financial incentives and payment schemes in healthcare systems: A review. Socio-Economic Planning Sciences, 72, 100901.

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.

Weismann, M., Ganske, S., & Delgado, O. (2020). Cleveland Clinic Florida “pay-for performance” reimbursement: why the best care does not always make the happiest patients. The CASE Journal.

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following: Health Care Delivery Models And Nursing Practice Essay Research

Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

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You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Must have less than 10% plagiarism Health Care Delivery Models And Nursing Practice Essay Research