Healthcare reform has remained an emotive and controversial issue in the United States. According to Jacobs and Skocpol (2016), the majority of Americans believe that healthcare is a basic need that should be accessible to everyone irrespective of their race, religion, gender, financial status, or any other demographic factor. However, coming with proper laws that define how such care should be financed is still a major issue. The most recent healthcare reform law that was passed in the United States is the 2010’s Patient Protection and Affordable Care, also known as the Affordable Care Act or Obamacare (Buckley, 2020). When President Trump came to power, he tried to introduce the American Health Care Act but it could not pass through both houses. As such, he signed Executive Order 13813, which focused on restructuring most of the aspects of the healthcare delivery system as defined in the Affordable Care Act (Buckley, 2020). The current federal regulation introduced by the current regime has a major effect on nursing practice and nurses’ roles and responsibilities. As Kimuyu (2018) observes, the role of a nurse is to provide care and support to patients irrespective of their financial capabilities. The new law may make healthcare services unaffordable to some patients. Such situations may complicate the work of nurses who may be forced to deny patients services they deserve.
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Quality measures and pay for performance have a significant effect on patient outcomes. According to Jacobs and Skocpol (2016), when a healthcare facility takes seriously the need to offer quality care, patients will receive the best service delivery possible at the institution. Factors such as the time when services are delivered and the approach of attending to patients will improve. Pay for performance tends to improve the morale of the medical staff. It makes them feel that their effort is appreciated. Quality measures and pay for performance affect nursing practice. They define the culture that an organization embraces in terms of offering care to patients. Nurses expect the management of institutions they work for to adopt and promote quality assurance policies and fair remuneration plans to enable them to undertake their primary role and responsibility of care and protection. However, it is important to note that these healthcare facilities need a reliable revenue source to sustain their operations. If the government cannot finance their healthcare needs through effective insurance coverage, then patients may be forced to find ways of paying for such services.
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