Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, 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 to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. Prepare this assignment according to the guidelines found in the APA Style Guide
As the U.S. health care system continues to undergo significant changes, reform and restructuring efforts have been initiated to enhance the quality, accessibility, and affordability of care. This paper will examine the actions taken to reform and restructure the U.S. health care delivery system and discuss the role of nurses within this evolving environment.
One major change introduced to reform the U.S. health care delivery system is the Affordable Care Act (ACA), signed into law in 2010. The ACA aimed to expand health insurance coverage, improve the quality of care, and reduce the cost of health care. It established health insurance marketplaces where individuals and small businesses can purchase coverage, expanded Medicaid eligibility, and prohibited insurance companies from denying coverage to individuals with pre-existing conditions (Kocher, Emanuel, & DeParle, 2010). Additionally, the ACA introduced several payment reforms, such as accountable care organizations (ACOs) and bundled payments, which incentivize providers to deliver high-quality, cost-effective care.
Another significant change is the shift towards value-based care. Traditionally, the U.S. health care system has operated under a fee-for-service model, where providers are paid based on the quantity of services rendered. However, this payment model has been criticized for incentivizing unnecessary procedures and leading to fragmented care. Value-based care focuses on quality and outcomes rather than volume, aligning payment with patient outcomes and cost-effectiveness. This approach encourages coordinated, patient-centered care and has led to the development of new care delivery models, such as patient-centered medical homes and care transitions programs (Rosenbaum, 2019).
In response to these changes, the role of nurses has evolved significantly. Nurses play a crucial role in care coordination, patient education, and health promotion, making them well-positioned to contribute to the reform and restructuring efforts. The ACA recognizes the importance of nurses in primary care by providing funding for nurse-managed health clinics and encouraging the expansion of nurse practitioner-led practices (Buerhaus et al., 2018). This has resulted in an increased demand for advanced practice registered nurses (APRNs), who are able to provide comprehensive primary care services and fill the gaps in access to care (Rosenbaum, 2017).
Furthermore, nurses are actively involved in quality improvement initiatives and the implementation of evidence-based practices. They contribute to interdisciplinary teams, working collaboratively with physicians, pharmacists, and other health care professionals to improve patient outcomes. Nurses utilize their expertise in data collection, monitoring, and analysis to drive continuous quality improvement efforts. They also play a vital role in patient safety, utilizing tools such as medication reconciliation, infection control protocols, and adherence to best practices to reduce errors and ensure patient well-being (Kendall-Gallagher, Aiken, Sloane, & Cimiotti, 2011).
In addition, nurses have a unique opportunity to engage in community health promotion and disease prevention activities. As the emphasis shifts towards population health management, nurses can address social determinants of health, promote healthy behaviors, and address health disparities among vulnerable populations. They can work with community organizations, schools, and employers to implement health promotion programs, deliver vaccinations, and conduct screenings (Erlingsson, 2019). This proactive approach not only improves individual health outcomes but also reduces the burden on the health care system by preventing the onset of chronic conditions.
In conclusion, reform and restructuring efforts have introduced significant changes to the U.S. health care delivery system. The ACA, value-based care, and the shift towards population health management are all aimed at improving the quality, accessibility, and affordability of care. Nurses play a crucial role within this changing environment by providing care coordination, patient education, and health promotion. They are actively involved in quality improvement initiatives, contribute to interdisciplinary teams, and engage in community health promotion activities. By leveraging their expertise and working collaboratively with other health care professionals, nurses can contribute to the success of these reform and restructuring efforts and ultimately improve patient outcomes.