Health Care Delivery Models and Nursing Practice
There have been several changes in the United States healthcare system. These changes have been effected to improve the safety and quality of health care services. The purpose of this paper is to explore a health care reform introduced recently, its effects on the roles and responsibilities of nurses, and the impact on nursing practice, and describe how pay for performance and quality measures affect patient outcomes, arising management and leadership roles for the professional nurses.
Health Care Law Reforms
The Sustaining Excellence in Medicaid Act of 2019 (HR 3253) is a recent federal law that reforms the health care system in the United States. Debbie Dingell, the Michigan representative, introduced the bill to the 116th Congress on 13th June 2019. It was signed into law on 6th August 2020. The bill was intended to provide some extensions in some provisions to restructure the Medicaid program (Dingell, 2019). The bill allowed Medicaid appropriations through to the 2024 fiscal year. The bill also authorized the state to enablefraud units to examine and consider complaints launched by non-institutionalized patients. This is a vital reform as it removes disparities arising from ignoring complaints from such patients who legally qualify for cover under the Medicaid program.
Sections II and III of the bill discuss the extension of the community health services demonstration program and extension of protection for Medicaid recipients ofhome and community-based services against spousal impoverishment, respectively. At times, Medicaid denies cover to spouses from low socioeconomic backgrounds. The bill extends cover to such people, including those receiving community-based and home-based medical services. Besides these reforms, the bill requires drug manufacturers always to include the cost of generic drugs in the determination of prices. This is intended to reduce the wholesale acquisition cost for new drugs and biologicals. Furthermore, the bill allows rebate calculations by excluding drug manufacturers from the definition of wholesalers dealing with drugs.
The bill affects nursing practice and the roles and responsibilities of nurses. For instance, the bill extends Medicaid coverage to spouses and protects them from impoverishment. This reform extends the roles and responsibilities of nurses. The nurse should identify patients affected by spousal poverty, limiting their access to quality care and educating them on the changes. By doing so, the nurse would assist impoverished individuals in accessing safe and quality health care services. The bill also adds to the role of nursing advocacy. Cleveland et al. (2019) note that nurses contribute to stronger health care delivery systems through patient advocacy. The nurse should assist non-institutionalized patients in lodging complaints and assist them in appealing if the latter are denied services. In this way, nurses would help many patients to get social justice.
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