Healthcare Reform and Nursing Profession - Term Paper Example

? Healthcare Reform and Nursing Profession Valerie Blemur NUR 3119 Professional Nursing: Concepts & Issues April 14, Healthcare Reform and Nursing Profession On March 23, 2010, President Obama signed the comprehensive healthcare reform into law which focuses on expanding coverage, control healthcare costs and improve the healthcare delivery system (Kaiser Family Foundation, 2011). The United States health care system comprises of a mixture of private and public sectors and is the most expensive in the world. According to the Organization for Economic Co-operation and Development, U.S. spends nearly 16% of the GDP on health with nearly $7,290 spent per person on health care cost (2009). A study conducted by the World Health Organization (1999) revealed that the health care system in United States ranked 37th in overall performance and 72nd in overall level of health among 191 nations reviewed in the study. Again, according to the U.S. Census Bureau (2012), the number of people without health insurance coverage rose from 49.0 million in 2009 to 49.9 million in 2010. A recent study also revealed that more than 44,800 excess deaths occur annually in U.S. due to lack of insurance (Wilper, Woolhandler, Lasser, McCormick, Bor, & Himmelstein, 2009). These were the major driving factors that led to the release of the health care reform act, also called the patient protection and affordable care act or the PPACA. The U.S. Health care reform act extends healthcare coverage to nearly 32 million people by providing subsidies for people who cannot afford insurance on their own, developing consumer-friendly rules clamped on insurers, offering tax breaks and developing marketplaces to shop for insurance plans (Frellick, 2010). This act gives new opportunities to nurses to deliver care and play a vital role in leading change. It challenges nurses to do more to prevent diseases, provide chronic care management especially to the growing geriatric population and offer end-of-life care that focus on comfort and compassion. Following are some of the provisions in the healthcare reform that affect nurses: Reauthorization of Title VIII Nursing Workforce Development Programs The new healthcare reform reauthorized some of the major workforce development grant programs like advanced education nursing, workforce diversity grants, nursing education, practice and retention grants and nursing student and nurse faculty loan programs (Health Resources and Services Administration, n.d.). In 2010, $243 million was allocated towards Nursing Workforce Development Programs (Wood, 2011). These programs have been made available to promote nursing education through loan repayment and scholarship programs and ensure that there are enough nurses to care for the growing healthcare needs in the future. These grant programs under the Public Health Service Act are the chief source of federal funding for nursing education (Frellick, 2010). Nurse-Managed Health Clinics The passage of the U.S. 2010 Health care reform act has resulted in the authorization of nurse-managed health clinics (NMHCs) which are nurse practice arrangements where advanced practice nurses serve as primary care providers, managers and administrators (Esperat, Hanson-Turton, Richardson, Debisette, & Rupinta, 2012). NMHCs provide health care services ranging from basic health promotion and disease prevention approaches to full service primary care including chronic disease management programs to the underserved populations and is associated with a school, college, university or department of nursing, federally qualified health center or an independent non-profit health or social service agency (Esperat et al., 2012). These NMHCs provide a ‘safety net’ for medically underserved populations in crucial health care access points in areas where primary care physicians are in short supply (Frellick, 2010). In 2010, the Human Resources and Services Administration released $14.8 million in prevention fund dollars to support grants to 10 NHMCs, but this funding was not renewed in 2011 and 2012 in an effort to reduce federal spending (Hansen-Turton, 2012). Demonstration Provision for Graduate Nurse Education This provision under the U.S. 2010 Health care reform act allows Graduate Medical Education monies to be directed to Advanced Practiced Registered Nursing programs to support clinical education (Frellick, 2010). This provision has addressed the long standing need of expanding clinical education in the field of nursing, which was one of the major barriers to Advanced Practice Registered Nurses enrollments. Funding for National Health Service Corps The U.S. 2010 Health care reform act has also increased funding for National Health Service Corps from $75 to $300 million, which would help the Corps to double its field strength by Sept. 30, 2010 (Frellick, 2010). The Corps offers scholarship and loan repayment programs that encourage medical, dental and mental health providers to serve in areas that have a shortage of specific healthcare professions (Frellick, 2010). This is a significant achievement considering the growing demands of healthcare in the country. National Healthcare Workforce Commission Based on the requirements established by the U.S. 2010 Health care reform act, an independent group of 15 members has been appointed to be part of this commission (U.S. Government Accountability Office, 2010). The primary purpose of the commission is to develop and evaluate the education and training activities in order to determine the needs of the healthcare workforce (Frellick, 2010). Based on their findings, the commission makes recommendations to the Congress and the Administration. Nurses are also an integral part of this commission. Nurse-Family Home Visit partnerships U.S. 2010 Health care reform act encourages nurse-family partnerships which is an evidence-based preventive intervention that is designed for low-income mothers who have had no previous live births. The three major goals of these home-visiting nurses are – improve fetal outcomes by encouraging pregnant women to eat healthy and avoid harmful substances like alcohol, tobacco and drugs, improve the health and development of children by helping parents provide more sensitive and competent care to their children and encourage parents to improve their lives by planning future pregnancies, completing their education, reducing dependence on public assistance and food stamps and find employment (Dawley, Loch, & Bindrich, 2007). This program has been found to be very beneficial especially in terms of its impact on pregnancy outcomes and improvements in a variety of maternal, child and social indicators. School-based Health Centers The U.S. 2010 Health care reform act has authorized a federal grant program for school-based health centers that provides $200 million over four years (Frellick, 2010). These school-based centers provide comprehensive preventive and primary healthcare services to students, especially the uninsured and underserved wherein the nurse is an integral part of the staff that works in these centers. These changes and regulations placed by the U.S. 2010 Health care reform act, gives nurses new opportunities to deliver care and play an integral role in leading change. Nurses therefore need to know how they can be part of the solution and make this reform work in the most effective manner. Following are some areas in which nurses can play a major role and assist in reforming the healthcare: Use Nurse-led Innovations Over the years nurses have revealed their expertise in expanding access to care and improving quality at low cost (Hassmiller, 2010). They have been credited with the development of innovative care models like nurse-managed health clinics, home visiting programs for low-income mothers and the traditional care models (Hassmiller, 2010). These innovative care models have significantly reduced repeat hospitalization rates among elderly patients with multiple chronic conditions (Hassmiller, 2010). Generate and use evidence-based Research Nurses should also work towards generating evidence based research. As innovators, they can help significantly in shaping the quality and safety of the healthcare system in the United States. Nursing research can help significantly in building the scientific foundation for clinical practice, prevention and improved patient outcomes and therefore they must support adequate funding (Hassmiller, 2010). One key example is the Robert Wood Johnson Foundation that is funding interdisciplinary nursing quality research initiative which is a program that links evidence based nursing care to improved patient outcomes (Hassmiller, 2010). Redesign Nursing Education Nurses need to equip themselves with the basic competencies to meet the growing demands of the aging and diverse society, especially with respect to elderly care. Their training should focus on a variety of aspects which include quality and safety, evidence based practice, research and leadership. A standardized residency program is essential to give the nurses on-the-job training and prepare them for clinical practice (Hassmiller, 2010). Expand the Scope of Practice Statutory and regulatory barriers should be removed so that advanced practice nurses can work in collaboration with physicians to provide cost-effective care and resolve issues concerning primary care shortages (Hassmiller, 2010). This need becomes more pronounced when we consider the 32 million Americans that would require health care services following the implementation of the U.S. 2010 Health care reform act. Diversify the Workforce The nursing workforce must also reflect diverse backgrounds and cultural values as the population of United States is almost exclusively driven by minorities. According to Izadi (2011), racial and ethnic minorities accounted for nearly 91.7% of the nation’s population growth in the past 10 years. Develop Leadership at Every Level Nurses are uniquely positioned to provide leadership in a variety of healthcare areas like reducing medical errors, improving quality, providing better coordination, increasing access to care and addressing workforce shortages (Hassmiller, 2010). Therefore, the U.S. 2010 Health care reform act offers great opportunities for nurses, especially those who have advanced education like a baccalaureate or higher degrees. The reform is an important step towards developing a better health care system in America. However it will not be possible to attain the goals of this reform without the active involvement of nurses. Nurses therefore have to step up and take leadership role as they fill the growing demands of primary care providers, work towards reducing healthcare cost and actively participate in strategy development, governance and policy making. References Dawley, K., Loch, J., & Bindrich, I. (2007). The nurse family partnership. American Journal of Nursing, 107(11), 60-67. Esperat, M. C., Hanson-Turton, T., Richardson, M., Debisette, A. T., & Rupinta. (2012). Nurse-managed health centers: Safety-net care through advanced nursing practice. Journal of American Academy of Nurse Practitioners, 24(1), 24-31. Frellick, M. (2010). Healthcare reform bill: What nurses need to know. Nursing Spectrum and Nurse Week. Retrieved from http://news.nurse.com/article/20100330/ NATIONAL01/104050041/0/frontpage Hansen-Turton, T. (2012). Nurse-managed health clinics provided badly needed primary care – but without funding, they and their patients are at risk. Retrieved from http://blog.rwjf.org/humancapital/2012/01/27/nurse-managed-health-clinics-provided-badly-needed-primary-care%E2%80%94but-without-funding-they-and-their-patients-are-at-risk/ Hassmiller, S. (2010). Nursing’s role in health care reform. American Nurse Today. Retrieved from http://www.americannursetoday.com/ article.aspx?id=7086&fid=6850 Health Resources and Services Administration. (n.d.). Nursing. Retrieved from http://bhpr.hrsa.gov/nursing/ Izadi, E. (2011). U.S. population growth minority driven, but not in D.C. DCentric. Retrieved from http://dcentric.wamu.org/2011/05/u-s-population-growth-minority-driven-but-not-in-d-c/ Kaiser Family Foundation. (2011). Focus on health reform: Summary of new health reform law. Retrieved from http://www.kff.org/healthreform/upload/8061.pdf Organization for Economic Co-operation and Development. (2009). Written statement to senate special committee on aging. Retrieved from http://www.oecd.org/ dataoecd/5/34/43800977.pdf U.S. Census Bureau. (2012). Income, poverty and health insurance coverage in the United States: 2010. Retrieved from http://www.census.gov/newsroom/ releases/archives/income_wealth/cb11-157.html Wilper, A.P., Woolhandler, S., Lasser, K.E., McCormick, D., Bor, D.H., & Himmelstein, D.U. (2009). Health Insurance and Mortality in US Adults. American Journal of Public Health, 99(12), 1-7. Wood, D. (2011). Federal funds for nurses: Are you getting your share. Retrieved from http://www.nursezone.com/nursing-news-events/more-news/Federal-Funds-for-Nurses-Are-You-Getting-Your-Share_36296.aspx World Health Organization. (1999). Measuring Overall Health System Performance for 191 Countries. Retrieved from http://www.who.int/healthinfo/paper30.pdf U.S. Government Accountability Office. (2010). GAO announces appointments to new national healthcare workforce commission. Retrieved from http://www.gao.gov/ press/nhcwc_2010sep30.html Read More