What is clear is that nurses will continue to transform the provision of care in the United States by leading cost reduction, quality enhancement, and removal of barriers to access through advancing roles as policy leaders, board members, and legislative action team members. The National Advisory Council on Nurse Education and Practice (NACNEP) (2010) found that a 10% increase in nurses holding Baccalaureate of Science in Nursing (BSN) degrees resulted in a 4% decrease in mortality. Nurses serving on governing boards of health-related organizations have both the opportunity and the obligation to impact healthcare cost, quality, and access. Nurses historically respond to changes in regulation and financing of healthcare with innovation and professional responsibility. 8 Ways Nurse Practitioners Help Reduce Healthcare Costs The sense of The minimally invasive and percutaneous ways: A tale of two Over the decades, advances in medicine have led to large increases in life-expectancy, a fact most are grateful for. Members of each Action Coalition campaign for policy changes needed in their state to impact nursing practice, access to health, and quality care. Dealy (2018) compared the current healthcare payment systems to a chess game. Retrieved from https://www.ccl.org/open-enrollment-programs/leadership-development-program/?gclid=EAIaIQobChMIy5G_ko654QIVS0sNCh15IwosEAAYASAAEgIVQfD_BwE, Centers for Medicare & Medicaid Services (2018a). Historical. Nurse practitioners provide a wide variety of quality health care services, such as: Medical cost trends: Behind the numbers 2019. Table 2. Implementation research studies supported by TDR's Impact Grants for Regional Priorities explored the root causes of catastrophic costs of tuberculosis (TB) treatment for households in several countries. Are Nurse Practitioners the Same As Doctors? Retrieved from https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nationalhealthaccountshistorical.html, Centers for Medicare & Medicaid Services (2018b). Outcomes of primary care delivery by nurse practitioners: Utilization Next, we describe the role nurse practitioners play in caring for vulnerable patients, and the specific responsibilities that fall under the purview of a nurse practitioner. However, you may wish to complete the modules as a refresher. There is more need than ever for nurses to analyze the evidence base and conduct scientific research to support interdisciplinary practice to improve value, through programs that enhance quality outcomes and emphasize prevention and wellness. Academic Medicine, 92(9), 1225-1227. doi: 10.1097/ACM.0000000000001854, Kavanagh, K. T., Cimiotti, J. P., Abusalem, S., & Coty, M.B. (2018, September 6). Omolola, E. A., Preston, M. A. Performance-based care places value on nursing care and demonstrates the important role of nurses as part of the healthcare team. To date, 22 states have removed language that limits APRN practice (AANP, 2018). Retrieved from https://www.hrsa.gov/advisorycommittees/bhpradvisory/nacnep/Reports/eighthreport.pdf, National Association of Insurance Commissioners.(2011). Nurses at every level of practice have assisted in the implementation of medical homes. American Nurse Today 3(11). Research conducted since the implementation of the ACA has shown reductions in uninsured persons; delay of necessary care; foregoing of necessary care; and increase in probability of a physician visit between 2011 and 2014 in low income non-elderly adults (Chen, Vargas-Bustamante & Ortega, 2016) and 19-25 year olds (Kotagal, Carle, Kessler, & Flum 2014). Perloff, J., DesRoches, C. M., & Buerhaus, P. (2015). Nurse educators have been linked through AACN to their government relations teams (AACN, 2019c). This paper summarizes several empirical, peer-reviewed articles supporting the quality of NP practice and is presented in two sections: 1) original research and 2) systematic reviews and meta-analyses. Nurses remain uniquely situated to shape healthcare due to their team approach, proximity to the bedside, and understanding of patient care within the hospital and the community (Institute of Medicine [IOM], 2010; Luther & Hart, 2014). (2012). The Affordable Care Act: 8 years later. Nurses serving on governing boards of health-related organizations have both the opportunity and the obligation to impact healthcare cost, quality, and access. (2017). Journal of American Academy of Orthopedic Surgery, 27(1), 1-11. doi:10.5435/JAAOS-D-17-00709, Shi, Q., Nellans, F. P., & Shi, L. (2015). Because of workforce needs and demographic and chronic disease trends, nurse practitioners (NPs) and physician assistants (PAs) are taking a larger role in the primary care of medically complex. Baker, J.J., Baker, R.W., & Dworkin, N.R. The Hospital Acquired Condition Reduction Program (HACRP) is a CMS program that financially penalizes hospitals that continue to have poor patient outcomes based on hospital-acquired conditions (HACs) such as central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) (Collins & Saylor, 2018b).VBP measures impacted by nursing care include CAUTI; CLABSI; clostridium difficile infection; site infections for colon surgeries and abdominal hysterectomies; 30-day readmission rates; and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey (CMS, 2017). Nurses serving on governing boards of health-related organizations have both the opportunity and the obligation to impact healthcare cost, quality, and access.The 2010 IOM report identified nurse involvement in healthcare decision making as a key component to create lasting change throughout healthcare reform efforts. & Gonzales, G. (2015). Sultz, H. A., Young, K. M. (2014). Health & Parenting Guide - Your Guide to Raising a Happy - WebMD June 04, 2010 Nurse Practitioners as an Underutilized Resource for Health Reform: Evidence-Based Demonstrations of Cost-Effectiveness Bauer JC J Am Acad Nurse Pract. School nurses have been instrumental in offering access to care for children through several ACA provisions: reimbursement for school health services and activities related to community-based prevention; and health education and counseling programs (e.g., immunizations, integrated behavioral health screening, suicide prevention activities, and substance use programs) (Maughan & Mazyck, 2014). Retrieved from: https://healthyschoolscampaign.org/uncategorized/the-affordable-care-act-and-school-nurses-enhancing-student-health-5745/, McKenna, R. M., Langellier, B. The purpose of this article is to discuss the unique roles offering empowerment to nurses to drive and respond to financial concerns in healthcare through the lens of the three aims of the ACA: reducing cost, improving quality and increasing access. Nurse Practitioners: Physician shortages in the US are predicted to reach between 34,600-88,000 by 2025 [2]. For nurses to make the greatest possible impact, there must be continued financial and educational support for research. The ACA provides an initial legislative framework that links these concepts directly to payment initiatives (Sultz & Young, 2014). The DNP-prepared nurse systematically applies scientific findings in practice and gathers outcome data to inform policy. Journal of Advanced Nursing, 73(7), 1735-1746. doi: 10.1111/jan.13287. Journal of Nursing Care Quality, 24(1), 5-9. doi: 10.1097/NCQ.0b013e31818f55b4, Robert Woods Johnson Foundation. The goals of this historic legislation included: 1) expanding Medicaid, 2) preserving both employer/job-based coverage and Medicare, and 3) promoting state control of insurance markets (Luther & Hart, 2014). Affordable care act and diabetes mellitus. Excellence in population health: A successful community-based care transitions program model. Nursing, 48(5), 43-47. doi: 10.1097/01.NURSE.0000531892.08687.b7, Collins, B. L. & Saylor, J. As stakeholders in the health of the communities where they live and work, nurses make their voices heard about issues of concern. Urology Times, 43(10), 24-20. Stronger impact has been shown by nurses who establish policy teams and legislative action committees to impact change across populations and into communities (Smith & Cleveland, 2018). Retrieved from https://www.aacnnursing.org/Policy-Advocacy/Get-Involved/University-Government-Relations-Collaborative, American Association of Nurse Practitioners. The position of nurse practitioner has been designed to be autonomous, meaning NPs can act as independent practitioners and are even able to open their own private practice. Health care disparities in the post-Affordable Care Act era. Cost of living - latest updates: ASOS launches 5 sample sale website Clinical nurse leaders. Completion of this training and obtainment of a certificate remains a requirement for IPC Lead Nurses. 2 With global shortages of primary care providers and decades . NPs are health care providers but also educators and researchers. Additionally, an aging population that will increase to over 78 million by 2035 (U.S. Census Bureau, 2018); an increasing number of individuals diagnosed with one or more chronic diseases due to obesity and/or a sedentary lifestyle; and provision of care for those who have not previously had healthcare due to disparate status will further increase healthcare demands and the need for efficiency in care (Salmond & Echevarria, 2017). Lee, G.M., Kleinman, K., Soumerai, S.B., Tse, A., Cole, B.M., Fridkin, S.K., . Health care finance: Basic tools for nonfinancial managers (5th ed.). The CMS track 30-day readmission rates for Acute Myocardial Infarction (AMI) at 15%; chronic obstructive pulmonary disease (COPD) at 19.7%; heart failure at 21.4%; pneumonia at 16.7%; and stroke at 11.8%. The Campaign for Action also provides funding for grants and awards, research, and training (Campaign, 2019). Reduce Overtime. Retrieved from: https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/Hospitals.html, Chen, J., Vargas-Bustamante, A., Mortenson, K. & Ortega, A. N. (2016). Currently, 28 million people remain uninsured and 30 million remain underinsured in the United States (Karpf, 2017). Quality of care, value in health spending, and availability of resources are not new priorities to the profession of nursing. Citation: Cleveland, K.A., Motter, T., Smith, Y., (May 31, 2019) "Affordable Care: Harnessing the Power of Nurses" OJIN: The Online Journal of Issues in Nursing Vol. Health care reform, care coordination and transformational leadership. A TF is an employee of a local community-based organization, such as an elderly service board. Journal of Nursing Administration, 41(7/8), 306-308. doi: 10.1097/NNA.0b013e31822509fa. The first attempt to control healthcare costs was introduced in 1989, when the Diagnosis Related Group (DRG) system replaced cost-based reimbursement. The implementation of a transitional care model in which nurse practitioners (NPs) conducted telehealth visits within 3 days of hospital discharge was associated with reduced health care costs and . The ACA highlights the priorities of nurses and exposes the disconnected nature in which healthcare is delivered in the United States (Luther & Hart, 2014). The DNP-prepared nurse holds expertise in translational research, providing evidence-based care, quality improvement, and systematic leadership. At the Masters level of nursing education, the clinical nurse leader (CNL) role was developed to address changing healthcare delivery systems. Older people projected to outnumber children for the first time in U.S. history. PDF Benefits of Removal of Barriers to APRN Practice: Reduce Healthcare These areas of expertise are all critical to the implementation of the ACA. The ability to access healthcare services is closely tied to employment, education, income and health insurance (Griffith, Evans & Bor, 2017). Federal Trade Commission (2014). In 2010, less than one percent of nurses held a doctorate level degree (IOM, 2010). Hospital value-based purchasing. Carver, M. C., Jessie, A. T. (2011). 3 Creative Ways to Cut Nurse Labor Costs | HealthLeaders Media Tracey Motter is Associate Dean of Undergraduate Programs at Kent State University College of Nursing, in Kent, OH.
Why Doesn T Malaysia Invade Singapore,
The Impact Of Training On Employee Performance Thesis,
Duke Alumni Gym Membership,
Men's Biggest Fear Is Being Laughed At,
Articles H