Academic Master

Health Care

Health Care Delivery Models and Nursing Practice

The United States, in order to improve the quality and cost of the healthcare system has restructured its healthcare delivery service to formulate needed demand as the US spent a fifth of its budget on medical services. The factors that have driven this idea to improve the value of care emerged from healthcare access problems, low patient outcomes, fragmentation, and rising costs. The lack of transparency, excessive spending, rising costs, and poor returns have forced the country’s healthcare system to implement fundamental reforms through ACA to improve the balance between quality and expenditure of care for patients’ satisfaction (Salmond and Echevarria, 2017). This paper evaluates the current ACA law and its effects on nursing practice, actions are taken for restructuring healthcare reforms, the medical service delivery system, and nursing practice models to help nurses in their role-playing within the ever-emerging healthcare environment.

Emerging Health Care Law and Effects on Nursing Practice

The implementation of the Affordable Care Act in the American House is effective and emerging healthcare legislation which was first proposed in March 2017, enacted in May 2017, and has still witnessed significant changes in various aspects of the US healthcare system. Through the enactment of ACA, the country took significant steps forwards to improve the quality of the healthcare system and to reduce healthcare services’ rising costs including repeated diagnostic testing and multiple unnecessary prescriptions. For instance, ACA legislation converts allotments according to Medicare and Medicaid funding per capita which has minimized the possibility for all the states around the country to expand Medicare and Medicaid costs. It is projected that with this legislation US health care would be allowed to use health conditions according to the age groups to define insurance premium prices that would allow lapses to Americans in their insurance coverage (Smeets et al., 2020).

Nurses’ Roles and Responsibilities

The implementation of this law ensures that nurses are positioned to be part of the paradigms and changes that occur in the healthcare sector through various approaches such as Value-Based Purchasing (VBP), Shared Saving Arrangements, and Pay for Performance (P4P) under the umbrella of American Affordable Care Act (AACA). These approaches conform to the new paradigms in the nursing practice to focus on patient-centered, affordable, and high-quality healthcare (Smeets et al., 2020). Moreover, nursing practice must consider the changes in the healthcare sector to renew its focus on patient-centered care, quality improvement, and care coordination with the medical service providers. Nurses in the nursing practice are also expected to partner with the patients, their families, peers, and friends to understand the social environment of the patients. Subsequently, after adopting these approaches nurses will be able to attain patient-defined effective health outcomes to advance the health of unhealthy members of the US population (Lateef et al, 2020).

Quality Measures, Pay for Performance, and Patient Outcomes

Pay for Performance and quality measures are the key aspects in the transformation of health care settings that significantly impact patient outcomes. Pay for Performance (P4P) programs are the strategic programs that provide penalties and potential rewards to healthcare providers evaluating their performance regarding the quality measures in the healthcare system. It is also projected in these strategic programs that proper implementation and designs of P4P programs can reduce unnecessary hospitalization which would definitely reduce the rising healthcare costs and would drive nurses in the healthcare system to perform their best in providing services to the unhealthy members of the population. However, it is also noted that the Affordable Care Act and Patient Protection demanded Department of Health and Human Services (HHS) 2010 it should implement Value-based Purchasing (VBP) to improve patient outcomes and the quality of care in Medicare and Medicaid. In general terms, Value-based Purchasing is the strategic set of performance-based payments to the health care service providers (Salmond and Echevarria, 2017). This set of effective strategies is specifically designed, planned, and implemented to link monetary incentives to set standards that should be provided to nurses based on their performance to attain value in the care service.

Furthermore, it was also focused in the demand report that P4P should be embraced by nurses from both private as well as public health care sectors to improve patient outcomes. Nurses through these approaches in the nursing practice are being tasked with lead roles and prominent responsibilities in the decision making so that they can perform improved leading roles to gain momentum and enhance quality services. Nurses in this respect have the responsibility to be more careful in handling patients as nursing practice ensures that efficient and effective procedures and strategies are utilized for better patient outcomes (Salmond and Echevarria, 2017).

Professional Nursing Leadership and Management Roles

Nursing leadership refers to the roles and responsibilities of the professionals from the arena of nursing who direct, oversee, and lead the nursing staff and organizational structures of healthcare processes so that nursing teams would provide quality patient care service. Leaders during the nursing practice oversee the management and development of patient care on the part of every individual nurse while providing him/her a healthy environment to grow professionally as well as interpersonally (Lateef et al, 2020).

ACA in this regard greatly impacts the nursing practice within the scope of nurses’ training as this legislation instills roles and responsibilities in a nurse through a reconceptualization of the innovative roles for patient care and also to resolve healthcare-related issues. The emerging and ever-changing ACA also advocates expansion of the nursing leadership and management as qualified and professional individuals can actively promote the setups where healthcare issues such as patients managing their life-long illnesses and other service-related issues would be well-catered. In addition to that, this legislation encourages nursing leadership, management, and staff to fully partner with caregivers to redevelop their capacity to identify, devise, and implement effective goals for the improvement of health care infrastructure (Salmond and Echevarria, 2017).

Predict Changes in Nursing Roles and Nursing Practice

Nursing practice plays a significant role in promoting health among the unhealthy members of society during times of illness. To achieve this, the following are curated two of the effective ways or predictions in which nursing practice and nursing roles can transform within the next 5 years.

  1. Online Education Nursing Practice Programs

Online education programs in nursing practice will motivate nurses to pursue higher educational degrees so that they can obtain a degree without sacrificing their family obligations or work-related roles and responsibilities. For instance, a Bachelor of Science and Nursing (BSN) degree earned through virtual means will help nurses to excel in their respective fields and professional careers as this degree introduce topics such as care coordination, patient care, health promotion, quality, and safety within the healthcare system. This strategy would open the gateway to higher education for the nurses along with a for-profit door to professional excellence.

  1. Increasing Leadership Opportunities

Nursing individuals are an integral part of the healthcare system and also require opportunities for leadership. Therefore, to transform nursing roles and nursing practice the US healthcare system should set forth leading roles and responsibilities for the nurses to reward their performance which would effectively improve patient outcomes. One thing which should be in consideration while meeting the need is that these opportunities require advanced degrees. Thus, to support nursing individuals in leading roles, management and the US healthcare authorities should take initiatives to shift nurses’ attention to advanced education.

In the nutshell, to motivate nurses to redevelop themselves through advanced degrees and leading roles as the true leaders they are, healthcare legislative authorities should have a deep appreciation of nurses’ values so that they can keep people healthy in all healthcare settings.


Lateef, A. M., & Mhlongo, E. M. (2020). A literature review on people-centered care and nursing practice in primary health care setting. Global Journal of Health Science, 12(2), 23-40.

Smeets, R. G., Kroese, M. E., Ruwaard, D., Hameleers, N., & Elissen, A. M. (2020). Person-centred and efficient care delivery for high-need, high-cost patients: Primary care professionals’ experiences. BMC family practice, 21(1), 1-9.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.



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