Health Care Delivery Models and Nursing Practice -US English Proficiency Required
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Patience Nehikhare
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Running Head: HEALTHCARE DELIVERY SYSTEM
THE U.S. HEALTHCARE DELIVERY SYSTEM 2
Healthcare Delivery System
Patience Nehikhare
Grand Canyon University
December 22, 2019
The U.S. Healthcare Delivery System
There is a rapid change within the healthcare system in the United States. The
changes that have occurred were made for the purpose of improving quality,
rewarding value and not volume, as well as integrating and coordinating the care
(Seshamani & Sen, 2018). As such, this paper will seek to put into consideration
current healthcare laws within the U.S. and the nurse’s role within this continuously
changing environment; the manner in which quality measures and pay for performance
affect patient outcomes. Furthermore, the emerging trends in the healthcare system,
professional nursing leadership, and management roles will be discussed.
The Emerging Health Care Laws and their Effects on Nursing Practice
One of the most crucial healthcare legislat ions that has been enacted in the United
States since the inception of Medicare and Medicaid in 1965 is the Affordable Care
Act (Obama, 2016). The ACA was enacted in 2010. Issues relat ing to affordability,
ease of access, and the care quality within the United States healthcare system were
some of the driving factors that formed the list of many t ime spanning challenges
that compiled the init iat ion of this legislat ion. Between 2010 to 2015 there was a
decrease in the number of uninsured cit izens in the U.S. by forty three percent as an
effect of the Affordable Care Act.
The payment systems in healthcare are undergoing some changes and the access to
care has also improved (Obama, 2016). The ACA promotes preventive healthcare
models that put emphasis on quality care, primary care, and the funding of community
health init iat ives (Lathrop and Hodnicki, 2014). Millions of previously uninsured cit izens
are also provided insurance coverage and also some healthcare areas that need
reforms so as to meet the needs of patients’ improved healthcare outcomes are
highly focused by the act. The act has an effect on nursing practice in several ways.
The first effect is that the act creates a high demand for healthcare professionals
that are sufficiently trained to provide healthcare services that are up to the acts’
standards. The second effect is that Advanced Practice Registered Nurses (APRNs)
who hold the Doctor of Nursing Practice (DNP) are required to be prepared so that
they can meet the increased needs through the provision of leadership skills in
community health centers. These professionals are also held accountable for direct ing
and advocating for future init iates as well as serving on interdisciplinary teams.
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Pay for Performance and Quality Measures effects on the outcome of Patients
Pay for Performance is used to describe value-based payments. It consists of
payment models that accompany financial benefits to the performance of the
provider. The main object ive of pay for performance is to convert healthcare to value
based medicine. In addit ion to that, it encourages health care providers toward care
that is value-based since it connects reimbursements to metric-driven outcomes.
Furthermore, it helps to promote patient sat isfact ion and best practices thus,
support ing payment with quality and value. The reason pay for performance was
introduced was for the purpose of ensuring there is improvement of the quality of
healthcare and the experience of patients. This is achieved by ensuring the healthcare
facilit ies accept practice and enforce the outlined healthcare best practices and
ensure the customer satisfact ion rat ings are high. Hospitals are usually reimbursed
based of their performance on a set of standardized domains of quality that are
reduction of cost, their efficiency, safety, clinical care, and the experience that is
centered on the caregiver. (Catalyst.nejm.org, 2018). This means that the expected
actions of the nurses are to ensure that they adhere to the specified safety
measures while offering their services to patients. They should also provide efficient
services and adequate clinical care.
Arisen Professional Nursing Leadership and Management Roles
Nursing as a service field is vibrant and challenging as it continuously requires leaders
and role models to engage and inspire the other upcoming nurses (Scully, 2015).
Therefore, there is a need to identify and develop leaders in the nursing profession so
that they can they can provide the leadership, inspirat ion and engagement that arise
from the emergent trends as well as be part of the frontrunners that promote quality
patient care
Among the roles that have evolved to a higher calling are leadership competences.
For the purpose of promoting patient safety and quality care strong leadership skills
are required for all levels of nursing. Partnership as a nursing leadership style is
paramount. It encourages the nurses to work with colleagues fully as partners through
collaboration. This plays the role in improving patient outcomes, reducing medical
errors and promoting employee retention. Addit ionally, it discourages workplace
bullying and other disruptive behaviors that continue to disrupt the healthcare
industry.
Healthcare Emergent Trends
One of the emergent trends in healthcare is that there have been changes in roles of
the c-suit in the hospital. The adoption of machine learning in predict ing and treating
condit ions will encourage and enable many healthcare facilit ies to create new
posit ions such as the innovation chief, and data analyt ics officers. These posit ions will
be crucial as organizations embrace technological init iat ives. Innovations and
init iat ives such as these will enable the hospitals to lower their operational and other
costs and also improve the patient’s experiences. The other posit ion that would be
essential is the Chief Nursing Informatics Officer (CNIO) due to the widespread
adoption of technology. Another emergent trend concerning the spending on
spending. Therefore, healthcare facilit ies will focus on saving costa spent on drugs.
This is because out of the eighteen percent of the United States gross domestic
product (GDP) consumed by health care, seventeen percent of it is spent on
prescript ion drugs. Therefore, data driven providers can reduce costs by deploying
means to track the spending on drugs with clinical outcomes.
The nursing practice and nursing roles would metamorphosize in the near future years
in order to respond the upcoming trends. One change that is likely to be experienced
is the intensified demand for nurses that are highly skilled. Nurses shortages will bring
about the need for hospitals to provide continuous sufficient training to fresh nurses
that are joining the industry.
References
Lathrop, B., & Hodnicki, D. (2014). The Affordable Care Act: Primary Care and the
Doctor
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of Nursing Practice Nurse. The Online Journal Of Issues In Nursing, 19(2). doi: DOI:
10.3912/OJIN.Vol198No02PPT02
NEJM Catalyst. (2018). What is Pay for Performance in Healthcare? – NEJM Catalyst.
Retrieved 19 November 2019, from https://catalyst.nejm.org/pay-for-performance-in-
healthcare/
Nole, D. (2018). 5 Healthcare trends to watch in 2019: From the launch of the Amazon-
JP
Morgan-Berkshire Hathaway health venture to more than $8 billion in digital health
deals, 2018 was a year of transformation and growth in healthcare. Retrieved 19
November 2019, from https://www.beckershospitalreview.com/healthcare-
information-technology/5-healthcare-trends-to-watch-in-2019.html
Obama, B. (2016). United States Health Care Reform. JAMA, 316(5), 525. doi:
10.1001/jama.2016.9797
Scully, N. (2015). Leadership in nursing: The importance of recognising inherent values
and
attributes to secure a posit ive future for the profession. Collegian, 22(4), 439-444.
doi: 10.1016/j.colegn.2014.09.004
Seshamani, M., & Sen, A. (2018). Moving Toward High-Value Health Care: Delivery
System Reform 2020 | Commonwealth Fund. Retrieved 19 November 2019, from
https://www.commonwealthfund.org/publicat ions/issue-briefs/2018/nov/high-value-
care-delivery-system-reform-2020
