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.

Title: Changes in the U.S. Health Care Delivery System: Reforms and Restructuring


The U.S. health care delivery system has undergone significant changes in recent years, as policymakers and stakeholders grapple with a multitude of challenges, including rising costs, unequal access to care, and the need for quality improvement. This paper will explore the reforms and restructuring efforts implemented within the U.S. health care system, with a specific focus on the role of nurses within this changing environment.

Reforms and Restructuring:

1. Affordable Care Act (ACA):

One of the most significant changes in the U.S. health care delivery system has been the implementation of the Affordable Care Act (ACA) in 2010. The ACA aimed to increase access to affordable health insurance, improve the quality and coordination of care, and lower health care costs. Through the establishment of state-based health insurance marketplaces and the expansion of Medicaid, millions of previously uninsured individuals gained access to health coverage.

The role of nurses in the ACA has been crucial. Nurses have embraced new roles and responsibilities, such as care coordinators and case managers, to ensure that patients receive comprehensive and coordinated care. The ACA also emphasized the importance of preventive care and health promotion, areas in which nurses have always played a vital role. Nurses have been actively involved in efforts to educate patients about preventive services and to promote healthier lifestyles, thereby contributing to the overarching goals of the ACA.

2. Value-Based Care:

Another significant change in the U.S. health care delivery system is the shift towards value-based care. Traditional fee-for-service reimbursement systems, which incentivize volume rather than quality, have been gradually replaced by payment models that reward value and outcomes. Value-based care focuses on improving patient outcomes, reducing health care costs, and promoting population health. It requires collaboration among various stakeholders, including nurses, to develop innovative care delivery models.

The Nurse’s Role in Value-Based Care:

Nurses play a critical role in driving and implementing value-based care. Their extensive clinical expertise, patient-centered approach, and ability to provide holistic care make them valuable assets in achieving improved outcomes. In value-based care models, nurses act as care coordinators, helping to ensure that patients receive appropriate and timely care, managing chronic conditions, and promoting continuity of care.

Nurses also contribute to the collection and analysis of data, which is essential for measuring and monitoring patient outcomes. By participating in quality improvement initiatives, nurses can identify areas for improvement, implement evidence-based practices, and contribute to better patient outcomes. Additionally, nurses are involved in patient education and shared decision-making, empowering patients to actively engage in their own care and make informed choices.

3. Telehealth and Digital Health Solutions:

Advancements in technology have enabled the expansion of telehealth and digital health solutions, which have fundamentally transformed the U.S. health care delivery system. Telehealth provides opportunities for remote monitoring, virtual consultations, and improved access to care, particularly for patients residing in underserved areas. Digital health solutions, including mobile applications and wearable devices, offer new avenues for patient engagement, chronic disease management, and health promotion.

Nurse’s Role in Telehealth and Digital Health:

Nurses are at the forefront of telehealth and digital health implementation. They provide telehealth services, such as remote monitoring, medication management, and patient education. Nurses can leverage digital health tools to enhance communication and engagement with patients, facilitating self-care and self-management. Additionally, nurses contribute to the development and evaluation of telehealth programs, ensuring the provision of safe and effective care delivery.


The U.S. health care delivery system has experienced significant changes aimed at addressing its numerous challenges. The reforms and restructuring efforts, including the Affordable Care Act, value-based care, and telehealth, have all played a crucial role in transforming the system. Throughout these changes, nurses have assumed new roles and responsibilities, actively contributing to the improvement of health care quality, access, and outcomes.

By embracing their expanding roles and leveraging their expertise, nurses have positioned themselves as key drivers of change within the evolving health care environment. As the U.S. health care delivery system continues to transform, nurses will continue to play a vital role in shaping and implementing innovative care delivery models, promoting patient-centered care, and ultimately improving population health.

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