Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 words, discuss action taken for reform and restructuring and the role of the nurse within this changing environment. Include the following: 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
Introduction
The U.S. health care delivery system has undergone significant changes in recent years, driven by the need for reform and restructuring. These changes aim to improve the quality and accessibility of health care services, address rising costs, and promote better patient outcomes. In this paper, we will discuss the actions taken for reform and restructuring of the U.S. health care delivery system, as well as the role of nurses in this changing environment.
Actions for Reform and Restructuring
One of the key actions taken for reform and restructuring of the U.S. health care delivery system was the enactment of the Affordable Care Act (ACA) in 2010. The ACA aimed to increase access to health insurance coverage, improve the quality and affordability of health care, and reduce health disparities. It introduced several major reforms, including the establishment of health insurance marketplaces, expansion of Medicaid eligibility, and implementation of essential health benefits. These changes helped millions of previously uninsured Americans gain access to health insurance coverage, reducing the financial burden of medical expenses and improving their overall health outcomes (Kohatsu, Chou, & Bryson, 2018).
Another significant action for reform and restructuring was the shift towards value-based care. Traditionally, the U.S. health care delivery system operated on a fee-for-service model, where providers were paid based on the number of services rendered, rather than the quality or outcomes of care. This incentivized volume over value and led to high costs and variable quality of care. In response, the Centers for Medicare and Medicaid Services (CMS) introduced several payment and care delivery models that aim to reward providers for delivering high-quality, cost-effective care. These models include accountable care organizations (ACOs), bundled payments, and the Hospital Readmissions Reduction Program (HRRP) (Gupta, 2019).
Furthermore, the U.S. health care delivery system has seen an increased focus on primary care and care coordination. Recognizing the importance of preventive care and the role of primary care providers in managing chronic conditions, efforts have been made to strengthen the primary care workforce and enhance care coordination across different health care settings. This is particularly important in addressing the growing burden of chronic diseases and promoting better patient outcomes. The shift towards team-based care, with nurses playing a central role in care coordination, has been instrumental in improving access to care, increasing patient satisfaction, and reducing costs (McDonald, Schultz, & Halasyamani, 2017).
Role of Nurses
In this changing environment, nurses play a crucial role in the reform and restructuring of the U.S. health care delivery system. As frontline providers and advocates for patients, nurses are uniquely positioned to contribute to the improvement of health care quality, accessibility, and affordability. Their role extends beyond direct patient care to include leadership, collaboration, and advocacy at various levels.
Nurses are instrumental in the implementation of value-based care models. Through their expertise in quality improvement, care coordination, and patient education, nurses can help organizations achieve the goals of these models. They play a vital role in ensuring the delivery of high-quality, cost-effective care by engaging in care planning, monitoring patient outcomes, and facilitating communication between different members of the health care team (Stevens, et al., 2018).
Nurses are also essential in the provision of primary care and the management of chronic conditions. With their holistic approach to care, nurses can address the physical, emotional, and social needs of patients, helping them effectively manage their health and prevent complications. They are often involved in patient education, self-management support, and care coordination, working closely with other members of the health care team to ensure seamless transitions of care (Bodenheimer & Sinsky, 2018).
In addition, nurses play a significant role in advocating for health care reform and policy changes that promote better patient outcomes. Their involvement in professional organizations, research initiatives, and policy development allows them to contribute to evidence-based decision-making and influence health care policy at the local, national, and international levels. Nurses can advocate for increased investment in primary care, improved access to care for underserved populations, and the integration of nursing perspectives in health care policymaking (Hawkins, 2019). Their active participation in policy discussions and political processes ensures that the voice of nursing is heard and that policies are aligned with patient needs and best practices.
Conclusion
The actions taken for reform and restructuring of the U.S. health care delivery system have had a significant impact on the role of nurses. Nurses are essential in the implementation of value-based care models, the provision of primary care, and the management of chronic conditions. Their expertise and advocacy skills contribute to improving health care quality, accessibility, and affordability. As the health care system continues to evolve, nurses will play a critical role in shaping its future and ensuring better patient outcomes.