The United States, in order to improve the quality and cost of the healthcare system, has restructured its healthcare delivery service to meet the needed demand, as the US spends 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, as well as the actions taken to restructure healthcare reforms, the medical service delivery system, and nursing practice models to help nurses play their roles 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 is an emerging healthcare legislation, which was first proposed in March 2017 and enacted in May 2017. It has still witnessed significant changes in various aspects of the US healthcare system. Through the enactment of ACA, the country took significant steps forward 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 of expanding Medicare and Medicaid costs for all the states around the country. It is projected that with this legislation, US healthcare would be allowed to use health conditions according to age groups to define insurance premium prices that would allow lapses in Americans’ 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 the American Affordable Care Act (AACA). These approaches conform to the new paradigms in nursing practice to focus on patient-centred, 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-centred care, quality improvement, and care coordination with medical service providers. Nurses in nursing practice are also expected to partner with 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 key aspects in the transformation of healthcare settings that significantly impact patient outcomes. Pay for Performance (P4P) programs are strategic programs that provide penalties and potential rewards to healthcare providers, evaluating their performance in terms of quality measures in the healthcare system. It is also projected in these strategic programs that proper implementation and design of P4P programs can reduce unnecessary hospitalization, which would definitely reduce rising healthcare costs and would drive nurses in the healthcare system to perform their best in providing services to unhealthy members of the population. However, it is also noted that the Affordable Care Act and Patient Protection demanded that the Department of Health and Human Services (HHS) implement Value-based Purchasing (VBP) in 2010 to improve patient outcomes and the quality of care in Medicare and Medicaid. In general, terms, Value-based Purchasing is a strategic set of performance-based payments to healthcare service providers (Salmond and Echevarria, 2017). This set of effective strategies is specifically designed, planned, and implemented to link monetary incentives to set standards based on nurses’ performance to attain value in care services.
Furthermore, the report also focused on the fact that P4P should be embraced by nurses from both private and public healthcare sectors to improve patient outcomes. Nurses, through these approaches in nursing practice, are being tasked with lead roles and prominent responsibilities in decision-making so that they can perform improved leadership 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 professionals from the arena of nursing who direct, oversee, and lead the nursing staff and organizational structures of healthcare processes so that nursing teams provide quality patient care services. Leaders during nursing practice oversee the management and development of patient care on the part of every individual nurse while providing him/her with a healthy environment to grow professionally as well as interpersonally (Lateef et al., 2020).
ACA, in this regard, greatly impacts nursing practice within the scope of nurses’ training, as this legislation instils roles and responsibilities in nurses through a reconceptualization of innovative roles in patient care and the resolution of healthcare-related issues. The emerging and ever-changing ACA also advocates the expansion of nursing leadership and management, as qualified and professional individuals can actively promote settings where healthcare issues, such as patients managing their lifelong illnesses and other service-related issues, can be well addressed. In addition, 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 healthcare infrastructure (Salmond and Echevarria, 2017).
Predict Changes in Nursing Roles and Nursing Practice
Nursing practice plays a significant role in promoting health among unhealthy members of society during times of illness. To achieve this, the following are two effective ways in which nursing practice and nursing roles can transform within the next 5 years.
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 in Nursing (BSN) degree earned through virtual means will help nurses excel in their respective fields and professional careers, as this degree introduces 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 nurses and a path to professional excellence.
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 nurses to reward their performance, which would effectively improve patient outcomes. One thing that should be taken into consideration while meeting this need is that these opportunities require advanced degrees. Thus, to support nursing individuals in leading roles, management and the US healthcare authorities should take the initiative to shift nurses’ attention to advanced education.
In a 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.
References
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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