Week 3 Discussion Board: Our Healthcare System Is A Big Busi

510 Week 3 Discussion Boardour Health Care System Is A Big Business

Our health care system is a big business, and the forces that are reshaping the system are largely economic. Service missions have been altered or they have merely disappeared, and new organizations have become important influences in the health care delivery system today. This week’s assignments offer a comprehensive overview of the complex health care delivery system in which nurses practice and policy approaches to address problems of cost, quality, and access.

Discussion Prompt 1: Identify three components of the Patient Protection and Affordable Care Act that went into effect in 2014 and discuss their impact or potential impact on the practice of nursing and medicine. Be specific as to what the provision states, who it affects, and the impact that it may have.

Discussion Prompt 2: Describe a type of health care spending that you consider wasteful or services that you consider have little or no benefit. Explain why you find the spending wasteful, and if eliminated, what impact it may have on the American public.

Paper For Above instruction

The Patient Protection and Affordable Care Act (ACA), enacted in 2010 and partially implemented in 2014, profoundly influenced the landscape of healthcare delivery and policy. Its provisions aimed to expand access to care, improve quality, and reduce costs. Three significant components introduced in 2014 include increased Medicaid expansion, the implementation of Accountable Care Organizations (ACOs), and the establishment of the Hospital Value-Based Purchasing Program. Each markedly impacts nursing and medical practice through policy shifts, care coordination, and quality improvement initiatives.

First, Medicaid expansion under the ACA, which allowed states to expand Medicaid eligibility to individuals earning up to 138% of the federal poverty level, dramatically increased access to healthcare services for vulnerable populations. For nurses and physicians, this expansion meant an increased patient base—particularly among low-income, uninsured populations—leading to greater demand for primary care, interdisciplinary coordination, and preventive services. The expansion potentially alleviates disparities in health outcomes, thus prompting healthcare practitioners to adapt their practice models to accommodate more diverse patient needs. Moreover, increased access to Medicaid also emphasizes the importance of care continuity and community-based interventions, which are central to nursing practice.

Second, the implementation of Accountable Care Organizations (ACOs) represented a shift towards value-based care. ACOs are networks of providers and hospitals that collaborate to provide coordinated, high-quality care to Medicare beneficiaries while reducing healthcare costs. For nurses, involvement in ACOs offers opportunities for leadership in care coordination, patient education, and quality improvement activities. The emphasis on preventative care and value aligns with nursing priorities for holistic, patient-centered approaches, promoting longer-term health management rather than episodic treatment. By incentivizing reducing preventable hospitalizations and readmissions, ACOs directly influence nursing practices related to patient education and transitional care.

Third, the Hospital Value-Based Purchasing (VBP) program links hospital reimbursement to performance on quality metrics, patient satisfaction, and safety indicators. This initiative incentivizes hospitals and healthcare providers to focus on quality improvement, transparency, and patient-centered care. Nurses play a vital role in achieving these metrics by ensuring optimal patient outcomes, adhering to clinical protocols, and promoting effective communication. The VBP program's focus on transparency fosters an environment where nursing care quality is scrutinized, encouraging ongoing professional development and adherence to best practices.

The impact of these ACA components extends beyond policy into clinical practice, demanding greater interdisciplinary collaboration, emphasis on preventive measures, and quality improvement. Nurses, being the largest segment of healthcare providers, are central to these initiatives. They are at the forefront of efforts to improve patient outcomes, coordinate care, and implement policy-driven changes that aim to control costs while enhancing quality.

In the context of wasteful healthcare spending, many analysts consider unnecessary diagnostic testing, particularly imaging scans, as an example. These tests are often ordered without clinical indications, leading to increased healthcare costs without necessarily improving patient outcomes. For instance, repeated imaging for uncomplicated low back pain or imaging for sinus infections in the absence of symptoms can be superfluous. These practices not only escalate costs but also expose patients to unnecessary radiation and potential follow-up procedures stemming from incidental findings.

Eliminating such wasteful practices could significantly reduce healthcare expenditures. These savings could be redirected towards essential services such as primary care, preventive medicine, and addressing social determinants of health. For example, reducing unnecessary imaging could save billions annually, freeing resources to improve access to care for underserved populations. Overall, tackling wasteful spending aligns with the ACA's goal of cost containment and resource efficiency.

In conclusion, ACA provisions like Medicaid expansion, ACO formation, and hospital value-based purchasing have reshaped healthcare delivery by emphasizing accessibility, quality, and cost-effectiveness. These policies require nurses and other healthcare professionals to adapt and lead initiatives in care coordination and quality improvement. Concurrently, addressing wasteful spending, such as unnecessary diagnostic testing, is vital for sustainable healthcare reform, ultimately benefiting the broader American public through enhanced resource allocation and improved health outcomes.

References

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