We are seeing rapid change in primary care as stakeholders are demanding higher quality healthcare at reduced costs. After reading the Cuenca (2017) and Shi, et al. (2017) articles, provide a synthesis-level evaluation of how you believe the patient-centered medical home and value-based payment models will (1) impact your personal practice as a nurse practitioner, and (2) transform the way primary care is delivered in the United States.
The demand for higher quality healthcare at reduced costs has led to rapid changes in primary care in the United States. Two articles, Cuenca (2017) and Shi et al. (2017), discuss the potential impact of the patient-centered medical home (PCMH) and value-based payment models on primary care. In this evaluation, we will explore how these models will affect the practice of nurse practitioners (NPs) and transform the delivery of primary care.
The PCMH model is a patient-centered approach that aims to provide comprehensive, coordinated, and accessible healthcare to patients. It emphasizes the role of primary care providers in managing patients’ overall health and well-being. Cuenca (2017) explains that NPs, as primary care providers, play a crucial role in the PCMH model by being responsible for the majority of patient visits and coordinating care across the healthcare system. As a nurse practitioner, the PCMH model will impact my practice in several ways.
Firstly, the PCMH model promotes teamwork and collaboration among healthcare providers. NPs will work closely with other primary care providers, specialists, and support staff to ensure the delivery of comprehensive and coordinated care. This will require effective communication and coordination skills to address the complex needs of patients. Furthermore, NPs will need to engage in shared decision-making with patients to incorporate their preferences and goals into the care plan. This shift from a provider-driven approach to a patient-centered approach will require NPs to adopt new communication and decision-making strategies.
Secondly, the PCMH model emphasizes the use of electronic health records (EHRs) to facilitate care coordination. NPs will need to become proficient in utilizing EHRs to access patient information, document care provided, and communicate with other healthcare providers. This will require training and ongoing education to ensure NPs are proficient in using these technological tools.
Lastly, the PCMH model emphasizes preventive care and population health management. NPs will play a critical role in promoting health maintenance, disease prevention, and chronic disease management. This may involve conducting regular screenings, providing health education to patients, and implementing evidence-based interventions for managing chronic conditions. As a nurse practitioner, I will need to stay updated with the latest evidence and guidelines to effectively promote preventive care and manage the health of patients under the PCMH model.
Moving on to the value-based payment models, Shi et al. (2017) explain that these models incentivize quality and efficiency in healthcare delivery by linking payment to performance outcomes. This shift from fee-for-service to value-based payment models will have a transformative impact on primary care delivery in the United States.
Firstly, value-based payment models will require primary care providers, including nurse practitioners, to demonstrate high-quality, cost-effective care. This may involve implementing evidence-based practice guidelines, using quality metrics to monitor performance, and participating in quality improvement initiatives. NPs will need to actively engage in performance measurement and improvement activities to ensure they meet the required standards.
Secondly, value-based payment models will encourage care coordination and integration. NPs will need to collaborate with other healthcare providers, community resources, and social support systems to deliver coordinated and seamless care. This may involve participating in care teams, attending multidisciplinary meetings, and exploring innovative models of care delivery such as telehealth and care transitions. NPs will need to adapt to new care delivery models and expand their scope of practice to provide comprehensive and integrated care.
Lastly, value-based payment models will increase the focus on population health management and preventive services. NPs will need to engage in health promotion activities, population-based screenings, and interventions that address social determinants of health. This may involve working with community organizations, public health agencies, and policymakers to implement strategies that improve the health outcomes of populations. NPs will need to adopt a population health perspective and actively participate in efforts to improve the overall health of communities.
In conclusion, the PCMH and value-based payment models will have significant impacts on the practice of nurse practitioners and the delivery of primary care in the United States. NPs will need to embrace teamwork, utilize EHRs effectively, prioritize preventive care, and engage in performance measurement and improvement activities. The transformation of primary care delivery will require NPs to adapt to new care delivery models, expand their scope of practice, and actively participate in population health management. By embracing these changes, NPs can play a vital role in meeting the demands for higher quality healthcare at reduced costs in primary care.