Affordable Care Act (ACA), and the aging of the population are the three major factors driving healthcare costs at this time (CMS, 2014). The nursing profession has the ability to contribute to refining the cost-effectiveness and efficiency of care through the delivery of evidenced-based treatment strategies to known populations with communal needs, and by advocating for polices that address the fundamental aspects that influence health and healthcare (Curley & Vitale, 2016, p. 5). The NE must be well-informed of laws entrenched in policy, as well as those central to both healthcare delivery systems and payment structures. Having knowledge of policy and law will enable the nurse leader to provide financial stability and sustain quality …show more content…
These performance reimbursements are known as value-based (Sherman, 2012). Value-based purchasing (VBP) outlined by Roussel et al. (2016) is a payment methodology that rewards quality of care through payment incentives and transparency. Some of the key elements comprise of: “a) Contracts that explicitly detail the responsibilities of employers as purchasers with insurance, managed care, and hospitals and physician groups as suppliers, b) Information to support the management of purchasing activities, c) Quality management to drive continuous improvement in the process of healthcare purchasing and in the delivery of healthcare services, d) Incentives to encourage and reward consumers, and e) Education to assist employees become better healthcare consumers” (p. 352). Hospitals are no longer being reimbursed for “never” events, which encompass situations a patient may encounter during a hospital stay, such as hospital-acquired infections, pressure ulcers, and falls. It is imperative for the nursing profession to hold knowledge and appreciation of how patient care outcomes influence the organizations monetary bottom-line. The ACA programs are a fee-for-service reimbursement into expenditures for comprehensive bundles of care that authorizes the National Pilot Program on payment bundling in Medicare, which will increase efficiency in the delivery of care and consequently
This public health policy paper will discuss and outline the Affordable Care Act (ACA) as well as barriers and controversies surrounding the policy and its relevance in nursing profession. The ACA will eventually affect everyone. Statistics reflecting United States health outcomes have proven the need for the initiation of policy formation within the United States healthcare system. “In March 2010, President Obama signed into law a comprehensive health reform, the Patient Protection and Affordable Care Act (ACA).” (Estes, Chapman, Dodd, Hollister, Harrington, 2013, p. 144) The ACA promotes preventive care—including related services and family planning—that should result in improved health outcomes and
The change to value based purchasing has bought many challenges to the healthcare industry. With the change to value-based purchasing for payments, it has changed how healthcare organization receive payment and delivery care. The advantage of have value based purchasing is that it improves the quality of care while reducing cost in an effort of aligning patient’s with the right provider and treatment plan (Minemyer, Jun 29, 2016). However, there are many disadvantages, such as it increases the patient volume as counteracting the reduction of procedure volume (Brown, B. & Crapo, 2016). Also it makes providers more responsible for care that is beyond the expected treatment of care needed (Minemyer, Jun 29, 2016). With quality measures tied
The Affordable Care Act was passed to provide American’s better access to health insurance coverage. In addition to better access the ACA improved health care quality and lowered health care cost. The ACA reformed health insurance by expanding coverage, holding insurance companies accountable, lowering health care costs, guaranteeing more choices, and enhancing the quality of care. Although some states have not implemented all the benefits of the ACA, most citizens do have access to health insurance. This paper will address some of the general highlights of the ACA, how it impacted healthcare and the nursing practice.
The Affordable Health Choices Act of 2009 allows nurses to focus on health care services as opposed to having to battle with insurance companies regarding coverage. It allows more time to be spent in the delivery of care, rather than focusing on the financial aspect. This bill improves
The Affordable Care Act, also known as Obamacare or ACA, was signed into law in March 2010 with the goal to expand insurance coverage to millions of Americans over a period of several years. Since its enactment six years ago, there have been millions of Americans that have gained access to coverage. The most notable of this population would be the disabled, mentally ill, and impoverished. In order to continue to provide quality outcomes for patients, especially patients of vulnerable populations, extra focus must be given to ensure access to healthcare, decreasing disparities, and harvesting improvement in areas such as preventative care, education, and maximizing quality of life. With this influx of people entering the healthcare field, the role of nurses and nurse leaders is also expected to change. Nursing scope of practice and education will be expanded to create an elite healthcare provider. This will include maximizing knowledge in areas of holistic care, education, and preventative care. The incorporation of the ACA into healthcare for vulnerable populations will have several implications for nurses including expanding leadership roles, changing the healthcare delivery model, and providing a broad range of care.
The Affordable Care Act reflected a shift from Treatment Model to Prevention Model, which requires well-educated nurses with more scientific understanding and skill in the process of care continuum – promotion and prevention to treatment. Since the medical field is undergoing a transformation, there is an increased need for highly qualified and competent nurses to provide safe and effective patient care in the new system. As the healthcare system has undergone dramatic changes over the last many years, nurses are now required to qualify well to provide more services than they did before. They also require to work as a team to provide optimum patient outcome. The Affordable Care Act also covers pre-existing conditions, which were once rejected by insurance providers. Such inclusion of the pre-existing conditions requires the nurses to increase their knowledge bases to cope
Over the last five years, the United States has implemented a new policy in which Americans will receive their health care benefits. This policy is known as the Patient Protection and Affordable Health Care Act which was implemented in 2010 through United States federal statue and signed into law by President Barack Obama. The intentions of the reform is to insure that all Americans have affordable access to health care benefits without struggling to afford the cost associated. The reform is broken down into nine title sections that affect all aspects of health care and changes that will be associated. In this paper, I will be discussing each of the title sections and how the changes will affect the field of nursing.
The Affordable Care Act of 2010 was a transformative piece of legislature aimed at putting health insurance back in the hands of the public. This comprehensive healthcare plan outlines several key provisions that apply to nursing. "The Affordable Care Act is working to make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike. The Patient Protection and Affordable Care Act clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation’s healthcare system (About, 2014).
Health care spending grew 3.7 percent in 2012 and the traditional way medicine was practiced had to change (Edlin, Goldman & Leive, 2014). The Affordable Care Act and Population Health was designed based on the concept of “The Triple Aim” to foster change in patient care by providing better care for individuals, better health for populations and decrease the cost of health through improved care (Perez, 2014). As a result, population management has moved to the front by linking services, reducing hospital admission, risk stratification, pursing preventive medicine, ensuring medication review and lowering health care cost. Several organizations have follow in the pursuit of population management by forming Accountable Care Organizations
Jim James, the CEO of _______, when faced with the reality of the Affordable Care Act (ACA) becoming law and taking effect, began to implement new rules and guidelines for his institution. Although improvising a strategic plan the institution is expected to follow as supplies and resources would soon be in critical demand. As CEO, he understood what was expected of the health care system, focusing mainly on the organizational needs that will help with the expanding or growing population and meeting the increased demand for the future. Via industrialized existing programs and building clinics that will accommodate the expected significant impact of the newly insured. “Eliminating ED crowding will take the collective involvement of healthcare workers, business leaders, politicians, the press, and the public” (Derlet & Richards, 2008). After much consideration, and a comprehensive evaluation of the documents for the new Affordable Care Act Jim James thought about the upcoming opportunities using a persuasive approach to transform the hospital. Since he stated that his most pressing desire is to find ways to connect the recipients in a way that will model changes in existing programs. Admittedly, we have a medical, acute care, care system- a system that waits until we become ill before it kicks into action instead of a healthcare system focused on helping us stay healthy (Schimpff, 2012). The justification, seeing the possibilities that are crucial in dealing with changes in
In 2010, the Patient Protection and Affordable Care Act, or PPACA gave many Americans the opportunity to have health care coverage that previously may have not been available to them. The reform is primarily aimed at decreasing the number of uninsured and underinsured Americans. The landscape of health care is changing and nursing is evolving alongside it. This health care overhaul gives nurses a vital role in leading the reform revolution. With more than three million strong, nursing is the biggest sector of the nation’s health care labor
“The ACA outlines some new health care arrangements, and with these structures will come new opportunities for new roles. Nurses have the opportunity to play a central role in transforming the health care system to create a more accessible, high-quality, and value-driven environment for patients. If the system is to capitalize on this opportunity, however, the
Healthcare Reform has been and still is a highly debated controversial political issue in this country. It has been a hot topic of past presidential campaigns, with many proposed solutions, none of which were enacted upon by Congress. The Affordable Care Act (ACA) was passed in 2010. This law or Obamacare, as it is commonly called, was designed to cover the 48 million Americans, including about 1 million in New Jersey who did not have health insurance. It is envisioned to provide seamless, affordable, quality care that is accessible to all. Great emphasis will be placed on transforming our current “sick care” hospital system into a community “health care” system of prevention and health promotion. This paper discusses the evolving and future roles of nurses under the new system. It also examines the proposals of a joint committee made up of members of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), as an initiative to help nurses in their new leadership roles to a healthier nation.
There are over three million nursing professional in United States and they make the largest segment of nation’s health care workforce. Nurses can play a vital role in helping to realize the objectives set forth in the 2010 affordable act, legislation that represents the broadest health care overhaul since the 1965 creation of Medicare and Medicaid program (IOM 2010). Due to the restricting barriers nurses were not able to respond effectively to the changing health care systems. In 2008, The