Changes to Reform the US Healthcare Delivery System

Introduction

The Healthcare Restructures Act is centered on health prevention and promotion. In 2010, US President Barrack Obama signed into law the Affordable Care Act (ACA) (Cleveland et al., 2019). The act paved the way for health insurance coverage for millions of Americans. Having an influx of citizens receiving medical insurance coverage escalated the need for healthcare services. However, there was a shortage of nurses with the surged need for healthcare services. The ACA advocated for quality and safe care and connected reimbursement and pay to the care provided by healthcare providers. Consequently, to determine the care offered, patients are offered surveys. With a focus on disease prevention and health promotion, many problems in healthcare were resolved (Rosa et al., 2019). Healthcare reform and laws were required to ensure quality and safe care was provided to people. The essay discusses action taken for restructuring and reform and the role of the nurse within the transforming environment.

Emerging Healthcare Laws and Effect on Nursing Practice, Role, and Responsibility

The Nurse and Healthcare Worker Protection Act (NHCWPA) and the Patient Protection and Affordable Care Act (PPACA) both center on the safety and health of patients and healthcare employees. With a higher consideration of patient results, the nurses should demonstrate they may offer efficient and effective care (Rosa et al., 2019). It puts higher demands for the need of nurse practitioners (NPs) and advanced practice nurses (APNs). A majority of patients choose APNs as doctors for preventive care since nurses are taught how to treat an individual wholly compared to the medicine strategy, which centers on the diagnosis (Ulrich et al., 2019). More APNs and NPs are required to supply the care patients require.

Further, Senator AI Franken and Representative John Conyers in 2015 initiated the NHCWPA. The act resolves safe patient handling and mobility (SPHM). Healthcare workers and nurses experience devastating pain and career-ending musculoskeletal disorders because of lifting their patients manually (Lutz et al., 2022). This act calls for the eradication of manual lifting; hence, employers should purchase mechanical tools and equipment to lift patients and early mobility therapies for patients. The SPHM initiatives have been confirmed to maintain patients’ safety, enhance the quality of care, and prevent injuries and falls. In addition, it has sustained nurses’ safety and prevented work-associated harms. Healthcare facilities with SPHM initiatives saved up to $103,000 on each nurse annually (Stadhouders et al., 2019). The decline in nurse and patient harm directly leads to reduced medical expenses.

Nurses have often been at the forefront of healthcare legislation. They have a critical role in maintaining the healthcare financial issues via incorporated programs with legislators, policy-makers, and management due to the urge to close the gap between healthcare-associated expenses, financing Medicare Trust, and insurance coverage scheme uncertainty (Ulrich et al., 2019). The laws have a direct influence on nursing responsibilities, practices, and roles. Further, the laws support higher education for nurses, which enhances patient care quality. The greater extent the more responsibility the nurses will get (Moran et al., 2023). Hence, APNs and NPs will have the same responsibilities and roles as doctors.

Quality Measures Pay for Performance, Patient Outcomes, and Effect on Nursing Practice

The Centers for Medicaid and Medicare Services (CMS) executed the incentive for improving patient care, lowering expenses, and holding healthcare providers responsible for no patient enhancements. According to CMS data, healthcare organizations and providers get reimbursed as per the quality of healthcare services offered. It is termed Pay for Performance (P4P), which comprises payment models that attribute financial disincentives or incentives to healthcare provider performance (Cleveland et al., 2019). Patient satisfaction and quality and safety of care are monitored by the Hospital Consumer Assessment of Health Plan Survey (HCAHPS) in healthcare facilities and the Healthcare Effectiveness Data and Information Set (HEDIS) within ambulatory care. This has aided in improving patient care outcomes through nurses offering quality and safe care. Three models of P4P influence hospital reimbursement from Medicaid and Medicare, comprising the Hospital Readmissions Reduction Program (HRRP), the Hospital Value-Based Purchasing Program (VBPP), and the Hospital-Acquired Condition Reduction Program. It has facilitated many nurses to provide quality care based on evidence and measured interventions to enhance better patient outcomes (HAC-RP) (Heinen et al., 2019). These models have helped to support better performance in nursing practice.

Furthermore, Medicare reimbursement is centered on patient outcomes, several healthcare facilities elected to employ nurses with bachelor’s degrees and master’s degrees. Nurses who hold higher degrees in nursing practice offer quality patient care. It has been noted that nurses have a focal role in patient satisfaction and quality of care, and efficient utilization of resources to offer evidence-based and patient-centered care. Nurses who are well-educated make resolutions concerning patient treatments and care, leading to better patient outcomes (Lutz et al., 2022). The nurses work persistently with patients and the majority of the HCAHPS concerns are regarding nursing care practice contributing to improved patient outcome.

Professional Nursing Management and Leadership Roles

These roles are required to maintain the transforming needs of healthcare. Managers and leaders of nurses are required to champion their workers and patients. As the main role in patient care, they should provide quality care to patients. Nurse leadership is critical for guiding care process reforms, evidence-based and quality interventions, and measurement of patient care outcomes. Nursing management and leadership roles are essential to the current healthcare trends (Stadhouders et al., 2019). The leaders and managers lead to professionalism at each level and set of policy development and care delivery. Nurse leaders formulate resolutions about patient care and organizational funds. They oversee the nurses who are working with patients (Rosa et al., 2019). In addition, it is the responsibility of nurse leaders to guarantee that nurses are offering proper and quality care to patients.

Predict Chang in Nursing Practice and Nursing Roles

Nursing practice and roles are transforming daily and more transformations are anticipated over the next five years. Nurses form the biggest team of healthcare experts and experience the details of the insurance and healthcare system sector (Ulrich et al., 2019). They may affect policies concerning healthcare to achieve the objectives and goals from the Future of Nursing report, hence, state legislators should restructure the laws concerning NPs and APNs working to the full extent of their training and education (Heinen et al., 2019). The hope is all states in the US will permit APNs to operate without the help of a medical doctor. States that permit APNS to operate without physicians depict better patient results as patients may access the care they require directly without waiting for another physician’s approval (Cleveland et al., 2019). APNS may be identified as contributing associates in healthcare as are the doctors.

Conclusion

Reforms in healthcare are required to sustain the changing healthcare needs. The reforms provide healthcare staff incentives to offer better and quality patient-oriented care. These reforms make nurses and patients safer while delivering care. Nurse leaders assist in making certain policies in the healthcare sector. Having nursing leaders operating closely with legislators and policy-makers in the health sector would be beneficial to patients, such as allowing APNs to operate with their training and educational capacity. Therefore, reforms in the health sector are required to benefit the delivery of the healthcare system.

References

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing, 24(2), 1-14. Web.

Heinen, M., Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378-2392. Web.

Lutz, B. J., Tabloski, P. A., & Turner, T. A. (2022). Categorizing national caregiver recommendations to support family caregivers and address unmet needs. Nursing Outlook, 70(6), 837-845. Web.

Moran, K. J., Burson, R., & Conrad, D. (2023). The doctor of nursing practice project: A framework for success. Jones & Bartlett Learning.

Rosa, W., Upvall, M., Beck, D., & Dossey, B. (2019). Nursing and sustainable development: Furthering the global agenda in uncertain times. OJIN: The Online Journal of Issues in Nursing, 24(2), 1-13. Web.

Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective healthcare cost-containment policies: A systematic review. Health Policy, 123(1), 71-79. Web.

Ulrich, B., Barden, C., Cassidy, L., & Varn-Davis, N. (2019). Critical care nurse work environments 2018: Findings and implications. Critical Care Nurse, 39(2), 67-84. Web.

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