NRS 440 Health Care Delivery Models and Nursing Practice

Sample Answer

The U.S. healthcare system continues to evolve through the implementation of healthcare delivery models based on emerging legislation and policies at the state and federal levels. These changes or reforms in healthcare focus on improving access to affordable and quality care to meet the rising demands.

Factors like an aging population, availability of health information, and improved healthcare coverage through health insurance are increasing the demand for innovative models like value-based care as advanced by the Centers for Medicare and Medicaid Services (CMS) (Brooks-LaSure et al., 2021).

The purpose of this paper is to discuss actions and reforms through current and emerging healthcare laws or federal regulations in the last five years to reform and restructure the system and nurses’ role within the changing landscape.

Health Care Law or Federal Regulation Build Back Better Act (H.R. 5376)
The Build Back Better Act, H.R. 5376 is one of the most significant recent laws that encompasses key provisions affecting the healthcare sector and access to services for patients, families, and the health population.

According to the Congressional Budget Office (CBO), three of its health provisions focus on reducing the number of uninsured Americans by 3.4 million. Fox et al. (2021) outline 11 major health coverage and financing provisions that the act focuses on to reform and restructure the healthcare sector.

For instance, the American Hospital Association (AHA) (2021) observes that this legislation expands eligibility for and value of health insurance marketplace subsidies for more coverage. The legislation extends the eligibility using the American Rescue Plan Act (ARPA) to 2025.

The legislation also affects the Medicare Part D program by reducing the cost of prescription drugs and spending and redesigning the benefits for those eligible (Human Rights Watch, 2021).

The legislation also addresses the Medicaid coverage gap, especially for the states that have not adopted the Affordable Care Act (ACA) provisions to expand their Medicaid to adults who meet the eligibility criteria. As such, this emerging federal policy has far-reaching implications for the development of innovative care models among organizations to increase accessibility, improve quality, and reduce costs for millions to get care services.

The expansion of Medicaid and other aspects of care as envisioned in this law will affect nursing practice and nurse’s roles and responsibilities in various ways.

Firstly, it implies that nursing practice will expand to accommodate the increased demand for care among different health populations and individuals.

Secondly, the nursing practice should also focus on improving quality care by enhancing training and continuous learning for nurses to understand these trends and develop effective evidence-based approaches to care delivery.

Advanced education and training allow nurses to respond to diverse patient needs and improve services by understanding their concerns. These changes also mean that nurses’ roles and responsibilities will expand to meet diverse needs (Nadash, 2022).

For instance, nurses are increasingly specializing in various areas to cater to patients with chronic diseases, special needs, and different populations, from pediatrics to geriatrics and mental health care. Nurses in their practice should meet professional standards and comply with the regulations in light of the changing healthcare delivery system.

Quality Measures and Pay for Performance

Innovative care delivery models focus on the quality of care as opposed to the quantity delivered to patients. The shift encourages innovation through financial reimbursements and incentives, treatment in ambulatory settings, and more focus on preventive measures based on the social determinants of health.

Quality measures improve patient safety through better interventions, especially those based on evidence (Brooks-LaSure et al., 2021). Quality measures use metrics to evaluate the quality of care patients get from providers.

These measures may entail readmission rates, satisfaction levels among patients, mortality rates, nurse-to-patient ratios, and the rate of healthcare-acquired infections (HAIs). Through this approach, nurses and other healthcare providers can reduce costs, improve healthcare outcomes, and enhance patient engagement. They can also adequately allocate scarce resources for better healthcare delivery.

Performance pay is a value-based approach to care where providers get rewarded for satisfying set quality and efficient goals and benchmarks. Through pay-for-performance measures, nurses focus on patient-centered care and implement evidence-based practice interventions the expectation from these models is that nurses will participate in innovative approaches to enhance quality and use data to inform their practice decisions (Melles et al., 2021).

Nurses should also collaborate with other professionals to enhance optimal care outcomes for patients by reducing harm through the prevention of medication errors, falls, infections, and other adverse events that impact patient safety.

Quality measures and pay for performance impact nursing practice, meaning that nurses will have expanded roles and responsibilities to meet patient needs. Nurses should be at the forefront of implementing recommended clinical practice guidelines and novel ways to offer patient care.

They must also promote patient care and act as advocates for better care delivery (Sarkar et al., 2020). They should also improve satisfaction levels among patients and adhere to medical care standards and nursing ethics. These models implore nurses to ensure data integrity to enhance quality performance and better care provision for patients.

Professional Nursing Leadership and Management Roles

The reforms and restructuring of the health sector imply emerging roles in nursing leadership and management to meet the trends. These managerial and specialist roles prepare nurse leaders and managers to influence and chart the way for their subordinates to integrate better interventions to improve patient safety and quality care (Wittman et al., 2021).

For instance, the nurse executive role means that nurses assume the responsibility to guide care provision and be part of interdisciplinary teams in patient care. The nurse informaticist role also emerges as nurses specialize in integrating nursing science and computer science to interpret and analyze big data to provide patient solutions.

As leaders, nurses should advocate better service delivery models for patients, improve welfare for colleagues, and influence policies aimed at expanding access to healthcare resources (Nadash, 2022). They should also be competent in their practice and specialties to increase patient confidence in their working and handling of patients.

These roles are essential for nurses to respond to the developing trends and promotion of patient safety. For instance, nurses learn innovative care models, leverage health technologies, and work in collaborative settings to deliver quality and safe patient care (Sarkar et al., 2020).

They also practice independently based on their training and expertise to expand healthcare coverage to different patient populations, especially those with limited access to health services.

Emerging Trends and Transformation of Nursing Practice and Roles
Two current and critical trends to transform nursing practice and the role of nursing include increased integration of health technologies to expand access to care, and emerging and reemergence of infectious diseases that will impact nursing practice and roles.

For instance, health technologies like artificial intelligence, telemedicine, precision medicine, and value-based interventions will enhance the role of nurses by imploring them to learn how to apply them to improve patient care and reduce workload.

Robotics will carry out some of the nursing roles due to increasing care demand as more people become susceptible to chronic conditions due to aging (Tortorella, et al., 2020). These technologies will help nurses to offer quality and effective care by leveraging their capabilities.

However, emerging and reemerging diseases will require nurses to take on additional roles and pursue specialty studies to enhance care delivery and implementation of evidence-based practice models (Gill et al., 2022). They also have to work as patient advocates, acquire disease surveillance skills, and focus more on primary health measures to prevent the spread of such conditions.

Conclusion

The significant transformation of the U.S. health system means that nurses will have expanded roles and responsibilities as they implement these provisions. The Build Back Better Act is a fundamental legislation that affects healthcare delivery through expanding access to quality and affordable care for millions of Americans. Nurses and the nursing practice must be prepared to leverage these provisions to enhance quality care delivery and patient safety.

References

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  Brooks-LaSure, C., Fowler, E., Seshamani, M., & Tsai, D. (2021). Innovation at the Centers for
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