NR 447 Week 1 Graded Discussion Topic: The Changing Aspects of Healthcare.
This week's graded discussion topic relates to the following Course Outcome
... [Show More] (CO).
• CO1 Apply leadership concepts, skills, and decision making in the provision of high-quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO 2)
Healthcare reform is a term that is ever present in our practice settings and will not disappear any time soon.
Review the article below and answer the following questions.
Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46. . doi:10.1016/S2155-8256(17)30097-https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S2155825617300972&site=eds-live&scope=site (Links to an external site.)Links to an external site.
1. Select one of the four challenges and expand on how your workforce has responded to the change.
2. How have these challenges affected the access to care for your patients?
3. What can you do to decrease the effect on your patients? Provide a specific example.
ANSWER
The Affordable Care Act (ACA) is the comprehensive health care reform law enacted on March 23, 2010, also referred to as ACA, PPACA or “Obamacare”. The ACA had three goals in mind, to make affordable health insurance available to all people, expand the Medicaid program to cover all adults with income below 138% of the federal poverty level and to support innovative medical care delivery designed to lower costs of healthcare (HealthCare.gov, 2017). The purpose of this act was to make health insurance available to more people, make it more affordable and easier to understand. Some of the ACA changes, children under age 26 can go under their parents’ plan, not denying benefits for pre-existing medical conditions, no lifetime limits, Medicaid expansion, and the healthcare insurance marketplace.
My workforce has responded to the changes, the ACA allows the federal government to withhold Medicare payments if the patient returns within 30 days of discharge for certain ailments such as heart attack or pneumonia (O'brien, 2013). The hospital has a discharge planning nurse who follows up with the patient after discharge and makes sure they have an appointment with their Primary Care Provider (PCP). The reduction of complications from infections, poorly performing hospitals get dinged financially, my hospital implements procedures and protocols to reduce hospital-acquired infection, like using a sepsis screening protocol.
I have selected the uncertainty of health care reform from the article “Four Challenges Facing the Nursing Workforce in the United States”. As stated in the above article “The 2016 elections gave Republicans control over the White House and Congress, and as promised, they initiated efforts to repeal and replace ACA” (Buerhaus, Skinner, Aucrbach & Staiger, 2017). The Republicans were not able to eliminate the ACA, but since President Donald Trump took office in 2017, the administration has repealed the ACA’s individual mandate and expanded short-term, limited-duration health plans, meaning they can’t be renewed and offers limited coverage to beneficiaries. Since 2017, ACA premiums have risen 34 percent, and the Congressional Budget office speculates that they’ll increase by extra 15 percent by next year.
The new administration and Congress want to modify the ACA in several ways:
• The elimination of personal and employer mandates to purchase health insurance;
• The promotion of health saving accounts;
• The emphasis on greater competition among insurers;
• Giving States more flexibility in determining what constitutes essential health benefits and coverage of pre-existing conditions (Buerhaus Et al. 2016).
The above challenges will affect the Registered Nurses’ workforce because fewer people will have health insurance. The demand for healthcare would fall below pre-ACA levels, hospitals would be faced with a large number of uninsured people with uncompensated care. Greater financial pressure would be placed on the hospitals which could lead to hospital closures or lower RN wages. The uninsured patients would be affected because they would not seek care for annual preventative services, such as blood pressure screening, cervical cancer screening, immunizations, and previous no co-pay, deductible or coinsurance for mammograms and colposcopies. Uninsured patients would only seek medical treatment for emergency care because of their inability to pay.
In regard to health care reform, how do nurses decrease the effects on the patients? First, they empower their patients by education. Nurses must inform patients of their rights and how to gain access to quality, affordable care. According to our textbook, the ACA is having an impact on the nursing profession and is providing new opportunities for nursing. Improvement of care and the health care delivery system, through more education, and evidence-based practice (Finkelman, 2016).
References:
Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46. doi:10.1016/S2155-8256(17)30097
Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality care, (3rd Ed.). Boston, MA: Pearson.
HealthCare.gov (2018). Affordable care act (ACA). HealthCare.gov
Retrieved from https://www.healthcare.gov/glossary/affordable-cae-act/ (Links to an external site.)Links to an external site.
O'Brien, K. (2013). 5 ways Obamacare affects hospitals, doctors and more. New Jersey Real-Time News.
Retrieved from https://www.nj.com/news/index.ssf/2013/09/5_ways_obamacare_afffects_hospitals_doctors_and_more.html (Links to an external site.)Links to an external site. [Show Less]