The Affordable Care Act and the Utilization of Nurse Practitioners: A Policy Analysis
Stephen Zombil
University of Massachusetts Amherst
Abstract The face of healthcare has been changing over the last decade. The role of nurse practitioners has become ever more important. This paper conducts a policy analysis as a systematic investigation of alternative policy options, for the emerging nationalized healthcare plan and the increased use of nurse practitioners. It looks at the goals of nationalized healthcare 's use of nurse practitioners and discusses to what extent this policy meets these goals. This paper begins with a detailing of the problem addressed by the policy and the goals and objectives of nationalized
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It looks at the goals of nationalized healthcare 's use of nurse practitioners and discusses to what extent this policy meets these goals. This paper begins with a detailing of the problem addressed by the policy and the goals and objectives of nationalized healthcare 's increased use of nurse practitioners. Next, alternatives to meeting the increased needs of the health industry, other than through the use of nurse practitioners, is presented, along with an evaluation of the impact of these alternatives. Once an evaluation of alternatives is complete, these alternatives are then ranked in order of which would be most effective in meeting the needs of nationalized healthcare. Lastly, a discussion regarding monitoring the implemented policy is given.
Nationalized Healthcare Policy and Challenges The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama, on March 23rd, 2010 (Buppert, 2015). This historic piece of health care reform legislation is scheduled for implementation over a four-year period. The legislation was created to make sure that all American residents have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs (The Patient Protection and Affordable Care Act, n.d.). There are nine primary components for this reform. These include: affordable health
In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and
While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.
The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing
Nurse Practitioners (NPs) play a key role in long term health care by ensuring provision of holistic healthcare services particularly in remote areas and in those areas that have few physicians. Currently, there is a concern where there is a shortage of physicians in nursing homes and in other critical health care services questioning the care being provided (Colwill, Cultice, & Kruse, 2008). Due to population growth,
The rapidly rising cost of health care in the United States has made access to medical care difficult for many citizens. Additionally, the number of uninsured is increasing because of job loss and reduction of employee benefits. This trend is projected to continue. The negative effect of reduced access to health care may have alarming effects on the economic well-being of the nation. The passage of the Patient Protection and Affordable Care Act (PPACA) marks the beginning of significant transformation in the United States’ health care systems. After multiple attempts to reform health care over the years, the nation’s leaders have succeeded in pushing through this landmark legislation that will ensure most Americans will have access to
Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)
The Patient Protection and Affordable Care Act (PPACA) is also known as the Affordable Care Act (ACA) this law is the landmark health reform legislation passed by the 111th Congress and was signed into law on March 23, 2010. The legislation includes a long list of health-related provisions that began taking effect in 2010 and will continue to be rolled out over the next four years. Provisions are intended to extend coverage to millions of uninsured Americans, to implement measures that will lower health care cost and improve system efficiency, and to eliminate industry practices that include rescission and denial of
The PPACA was structured to accomplish insurance reform through several avenues (Vincent & Reed, 2014). Medicaid program expansion and the individual mandate are two of the primary elements of healthcare insurance and finance reform (Vincent & Reed, 2014). Additionally preventative health services delivered without cost, removal of health insurance exclusions for preexisting conditions, allowing children under the age of 26 to remain on their parent’s healthcare insurance, and gradually decreasing the out of pocket costs for Medicare Part D participants are mandated by the provisions of the PPACA (Vincent & Reed, 2014).
Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.
Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the
As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).
“Nurse practitioners were created in an environment of informal training, a lack of credentialing processes, increasing sophistication of medical care, and opposition” (Medscape). In 1970, Nurse practitioners stated that patients were pleased with their improved convenience of health care services. In the early 1980s, health care encountered challenges to clarify their scope of practice and nursing organizations offered titles and certifications to meet federal regulations for reimbursement (Medscape). Nurse practitioners faced several barriers to gain provider status and needed direct reimbursement to practice as independent health care providers. An aggressive campaign was created and nurse practitioners achieved legislation over 20 years, resulting in provider status in 1997.
The face of healthcare has been changing over the last decade. The role of nurse practitioners has become ever more important. This paper conducts a policy analysis as a systematic investigation of alternative policy options, for the emerging nationalized healthcare plan and the increased use of nurse practitioners. It looks at the goals of nationalized healthcare 's use of nurse practitioners and discusses to what extent this policy meets these goals. This paper begins with a detailing of the problem addressed by the policy and the goals and objectives of nationalized healthcare 's increased use of nurse practitioners. Next, alternatives to meeting the increased needs of the health industry,
Healthcare has been around for many decades. It has always been a problem for many Americans. Whether it be too expensive or individuals do not qualify to be covered under medical insurance. Many Americans have spent years trying to get some type of medical coverage. This can be a frustrating task because it is not easy. In 2010 the Affordable Care Act was signed into law by congress. This law made healthcare affordable and accessible to all Americans. While it is a good attempt at changing previous healthcare rules, many Americans still go uninsured. In this paper I will look at two components the American Nursing Association feel need to be reformed.
Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession