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Health Care Delivery Models and Nursing Practice

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Health Care Delivery Models and Nursing Practice

Current or emerging health care law or federal regulation in United States

Some medical scholars urge that healthcare is a basic practice that should be accessible to

everyone regardless of gender, financial status, religion, race, or other demographic factors.
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Factors pushing healthcare reforms in the United States include healthcare disparities, access

challenges, high and unsustainable costs, and suboptimal costs, among other health care related

challenges Americans face. 

Cost and quality concerns and emerging trends in economic, social, and disease

demographics led to the urgency for the need for healthcare transformation in the United States

(Brown,2021). A recent federal law reforming healthcare in the United States is the Sustaining

Excellence in Medicaid Act of 2019. The Act was first introduced into Congress on June 13,

2020, and signed into law on August 6, 2020. The Act was introduced and sponsored by

Michigan representative Debbie Dingell. The bill aims at restructuring the Medicaid program by

offering extensions in some of its provisions. One of the reforms made through the 2019 Act is

enabling the appropriations of Medicaid to 2024. The second healthcare reform under this Act is

advancing Medicaid eligibility for people and protecting them from adverse poverty. For

instance, Americans from lower socio-economic levels are sometimes denied medical coverage

since the Medicaid program does not extend. Fortunately, low-income Americans are well

catered for in this bill. addition, to these reforms, the Medicaid Act 2019 enacted the

requirements for drug manufacturers to include the costs for generic drugs. Another reform in

Medicaid outlined in the Act is allowing the stated fraud units within the program to evaluate and

examine complaints from the non-member. This reform is significant as it reduces disparities that

occur due to ignorance of complaints from such patients, yet they deserve the coverage in the

Medicaid program. The current federal act significantly affects the nursing practice, roles, and

responsibilities. Nurses contribute to and lead transformative changes in the healthcare industry

as an inter-professional team. The nurses have a major role in shaping these changes and must

also have a deeper understanding of the factors of the change in the nursing practice. The
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healthcare services in United States are sometimes unaffordable to some patients. Such scenarios

might complicate nurses' operations, resulting in patients being denied the care they deserve.

Nurses then have to take the role and responsibility of providing health care and support to

patients irrespective of their financial status.

Quality measures and pay for performance 

Quality measures and performance pay greatly impact the patient's outcome. For

instance, when a medical care facility takes the initiative to offer quality care to patients, the

patients access the best healthcare services from the hospitals. Time and the model of attending

to the patients are very important. For example, when timely healthcare services are delivered to

patients, how the patients are treated will improve, and patients will experience quality delivery.

Pay for the performance will motivate the healthcare staff. Paying for the services will make the

nurses feel that their efforts have been recognized and appreciated. Therefore, quality measures

and pay for performance affect nursing practice significantly. Quality measures and pay for

performance define the healthcare culture that a medical institution takes in offering quality care

to patients (Waters et al., 2022). The nurses expect the leadership of the healthcare organizations

to engage in and promote quality assurance and fair policies and plans to ensure they undertake

their primary roles and responsibilities of care and protection effectively. Therefore, healthcare

facilities require reliable funding to sustain quality medical care operations. The government is

expected to finance healthcare needs. However, when the government cannot offer support,

healthcare institutions are forced to seek insurance coverage, which might cause the patients to

look for means of paying for such services. Nurses play a significant role in such situations. For

instance, they have to ensure the patients are in a position to pay their medical bills by advising

them on how to handle the financial challenges.

Professional nursing leadership and management roles 

The recent federal reform and restructure of the healthcare in the United States healthcare

delivery system resulted in the development of new nursing leadership and management roles,

especially on emerging issues in the nursing profession (Cleveland et al., 2022). Nurses have

new roles as psychologists in healthcare institutions. In offering and promoting quality

healthcare services and patient safety in diverse situations, it is evident that nurses interact with

patients more than any other medical practitioner. At times, nurses are forced to address the

financial difficulties that some patients may be experiencing. Some patients even fear that they

may be denied medical care due to a lack of insurance coverage. According to some medical

scholar patients' mental health is very critical as it can affect their ability to heal from a given

disease. Therefore, nurses must adapt to new roles to ensure patients' issues are well addressed.

Sometimes nurses take a different leadership role in assisting patients in finding ways of clearing

their bills. The new roles cannot be defined as the primary roles of nursing. However, the roles

are vital in responding to emerging trends and promoting patient safety and quality care in the

diverse healthcare setting. For instance, as new federal laws arise in the nursing field, nurses

have to redefine their roles within the healthcare sector that are in line with emerging trends.

Emerging Trends

The nursing sector is evolving and changing daily. New trends are emerging in the

industry in direct response to the current and emerging federal and state healthcare acts and

regulations. One of the significant emerging trends in nursing is the role of nursing as

counsellors for financially strained patients. Another transformation witnessed is the nursing

leadership role in assisting patients in clearing their hospital bills. I believe within the next five

years, the role of nurses and the practice of nursing will be one of the essential services that
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nurse practitioners have to offer in response to upcoming trends or predicted issues in the

healthcare industry. In the United States, many people rely on government-sponsored programs

as outlined in the Medicaid Act, therefore most patients are not aware of the quality healthcare

insurance covers they can seek. I predict that nurses might be significant advisers to patients on

the best medical insurance solutions in the coming five years or more. The nurses might also

assist their patients by enlightening them on the numerous insurance institutions offering

healthcare coverage. The new nursing role is to give the patients a broader insurance selection

platform that suits their medical needs and responds to trends or predicted health-related issues.
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References

Brown, E. A. (2021). Measuring the impact of the affordable care act medicaid expansion on

access to primary care using an interrupted time series approach. Health Research Policy

and Systems, 19, 1-10. doi:https://doi.org/10.1186/s12961-021-00730-0

Cleveland, Kimberly, JD, MSN, RN,C.-M.B.C., C.-M.P.C., Motter, Tracey, DNP,M.S.N., R.N.,

Rudsill, Pamela, DNP, RN, MSN, NEA-BC,F.A.A.N., F.A.O.N.L., & Benson, L., B.S.N.

(2022). The affordable care act: Considerations for leveraging the power of

nursing. Online Journal of Issues in Nursing, 27(2), 1-8.

doi:https://doi.org/10.3912/OJIN.Vol27No02Man01

Waters, T. M., Burns, N., Kaplan, C. M., Graetz, I., Benitez, J., Cardarelli, R., & Daniels, M. J.

(2022). Combined impact of Medicare’s hospital pay for performance programs on

quality and safety outcomes is mixed.  BMC Health Services Research, 22, 1-8.

doi:https://doi.org/10.1186/s12913-022-08348-w