The document discusses provisions of the Affordable Care Act that provide funding to address the primary care provider shortage in the United States. It notes that the ACA invests in expanding the primary care workforce through funding for medical education and support for nurses and nurse practitioners. In particular, it allocates grants and loan repayment programs to nursing schools to boost enrollment and support for students. The document argues this increased funding for primary care training and education is critical to fulfill the goals of the ACA to expand access and improve healthcare outcomes in the face of growing demand for primary care services.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
This research paper outlines the idea of cost-effective health care, which minimizes 'unnecessary' patients tests and procedures that do not improve patient outcomes. The analysis focused on examining current trends in cost-effective health care, the rise of modern medical technologies involved in cost-effective health care, and the benefits of the U.S. implementing a cost-effective health care system. Mrs. McCallister and Dr. Pahwa were instrumental in the formation of this paper.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
This research paper outlines the idea of cost-effective health care, which minimizes 'unnecessary' patients tests and procedures that do not improve patient outcomes. The analysis focused on examining current trends in cost-effective health care, the rise of modern medical technologies involved in cost-effective health care, and the benefits of the U.S. implementing a cost-effective health care system. Mrs. McCallister and Dr. Pahwa were instrumental in the formation of this paper.
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
Current healthcare trends and jobs outlook for 2025needppthelp
This is a team assignment for HCAD 600 for the MS program in Healthcare Administration by UMUC. This presentation is a analysis of the current healthcare trends and job outlook for 2025 to be presented to the HR committee of Board of Directors of a healthcare organization to address workforce shortages in key healthcare areas.
Past President Franklin Roosevelt and Lyndon B. Johnson enacted ACTS and legislation to help the United States Poor to ensure they has proper health care insurance. “The Social Security Act was passed by Congress as part of President Roosevelt’s Second New Deal agenda. In signing the Act into law on August 14, 1935, Roosevelt became the first president to advocate for and create legislation for the provision of governmental assistance for the elderly at the federal level” (CSU, 2015). Considering the new policies and new developments of the country to ensure that housing, food, and work was also available. Time was surely of the essence considering it was the turn of the century and the United States was implementing new changes and programs within the United States.
Nachiket Mor IT for primary healthcare in indiaPankaj Gupta
An Approach Towards Health Systems Design in India,
Information technology for Primary Healthcare in India,
Johns Hopkins University,
March 2020,
13 citations - [Streveler and Gupta, 2019] - Health Systems for New India - Niti Aayog Book published in Nov 2019,
eObjects - eClaims, eDischarge, ePrescription, eEncounter, eReferral,
HCAD 600 Group 2: The Future of Healthcare: Macro-Trends Effect on Healthcare...HCADGROUP2
The healthcare industry has been growing steadily for a number of years - mainly because people depend on health services no matter what the economic climate (Torpey, 2014 p. 29). By 2022, the healthcare industry, which is projected to be among the fastest-growing industries in the US. Economy, will add over 4 million jobs for both current and future healthcare professionals (Torpey, 2014 p28). The majority of these jobs will be most prevalent in the industries of hospitals, offices of health practitioners, nursing and residential care facilities, home healthcare services, and outpatient, laboratory, and other ambulatory services (Torpey). Industrial growth within the U.S. healthcare system will be a direct byproduct of macro-trends emerging in the U.S. healthcare system, such as those related to the overall economy, morphing demographics, personal lifestyles and behaviors, emerging technologies, and evolving federal and state government policies. As a result, this growing, heavily diverse healthcare industry will present an inordinate amount of career opportunities for healthcare managers in the next 10 years.
A Comparative Analysis Of The UK And US Health Care Systemsabbiemc
- Published a comparative review of health systems of the National Health Service in the United Kingdom and the varying approaches to health systems in the United States
- Developed research question, conducted interviews, utilized PubMed and similar research database systems, performed literature review, and prepared and submitted for publication
In the coming years the United States will find themselves going through a number of changes within the Social Security Administration which will affect the Health Care Industry as we know it “Hospital size has long been an area of discussion and debate in the U.S. healthcare industry. Questions have consistently focused on cost management or efficiency in large versus small hospitals. A persistent question among researchers is whether efficiencies are associated with larger facilities through economies of scale, or if there are alternate scenarios that play a significant part in hospital cost and efficiency” (2009, JHM). Since the Affordable Health Care Act was established it made obtaining health care much more affordable and accessible, but at the same time there has to be some cut back.
Got Healthcare? Affordable Care Act PP (July 2013)Kevin Kane
The Affordable Care Act presentation that Citizen Action of Wisconsin presents with around the state. How the ACA impacts you and how to talk about it.
Nursing workforce diversity updates and anticipated trendsJulia Michaels
Presentation by Dr. Shanita D. Williams, PhD, MPH, APRN, Chief, Nursing Education and Practice Branch, Division of Nursing and Public Health, Bureau of Health Workforce, HRSA
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
Current healthcare trends and jobs outlook for 2025needppthelp
This is a team assignment for HCAD 600 for the MS program in Healthcare Administration by UMUC. This presentation is a analysis of the current healthcare trends and job outlook for 2025 to be presented to the HR committee of Board of Directors of a healthcare organization to address workforce shortages in key healthcare areas.
Past President Franklin Roosevelt and Lyndon B. Johnson enacted ACTS and legislation to help the United States Poor to ensure they has proper health care insurance. “The Social Security Act was passed by Congress as part of President Roosevelt’s Second New Deal agenda. In signing the Act into law on August 14, 1935, Roosevelt became the first president to advocate for and create legislation for the provision of governmental assistance for the elderly at the federal level” (CSU, 2015). Considering the new policies and new developments of the country to ensure that housing, food, and work was also available. Time was surely of the essence considering it was the turn of the century and the United States was implementing new changes and programs within the United States.
Nachiket Mor IT for primary healthcare in indiaPankaj Gupta
An Approach Towards Health Systems Design in India,
Information technology for Primary Healthcare in India,
Johns Hopkins University,
March 2020,
13 citations - [Streveler and Gupta, 2019] - Health Systems for New India - Niti Aayog Book published in Nov 2019,
eObjects - eClaims, eDischarge, ePrescription, eEncounter, eReferral,
HCAD 600 Group 2: The Future of Healthcare: Macro-Trends Effect on Healthcare...HCADGROUP2
The healthcare industry has been growing steadily for a number of years - mainly because people depend on health services no matter what the economic climate (Torpey, 2014 p. 29). By 2022, the healthcare industry, which is projected to be among the fastest-growing industries in the US. Economy, will add over 4 million jobs for both current and future healthcare professionals (Torpey, 2014 p28). The majority of these jobs will be most prevalent in the industries of hospitals, offices of health practitioners, nursing and residential care facilities, home healthcare services, and outpatient, laboratory, and other ambulatory services (Torpey). Industrial growth within the U.S. healthcare system will be a direct byproduct of macro-trends emerging in the U.S. healthcare system, such as those related to the overall economy, morphing demographics, personal lifestyles and behaviors, emerging technologies, and evolving federal and state government policies. As a result, this growing, heavily diverse healthcare industry will present an inordinate amount of career opportunities for healthcare managers in the next 10 years.
A Comparative Analysis Of The UK And US Health Care Systemsabbiemc
- Published a comparative review of health systems of the National Health Service in the United Kingdom and the varying approaches to health systems in the United States
- Developed research question, conducted interviews, utilized PubMed and similar research database systems, performed literature review, and prepared and submitted for publication
In the coming years the United States will find themselves going through a number of changes within the Social Security Administration which will affect the Health Care Industry as we know it “Hospital size has long been an area of discussion and debate in the U.S. healthcare industry. Questions have consistently focused on cost management or efficiency in large versus small hospitals. A persistent question among researchers is whether efficiencies are associated with larger facilities through economies of scale, or if there are alternate scenarios that play a significant part in hospital cost and efficiency” (2009, JHM). Since the Affordable Health Care Act was established it made obtaining health care much more affordable and accessible, but at the same time there has to be some cut back.
Got Healthcare? Affordable Care Act PP (July 2013)Kevin Kane
The Affordable Care Act presentation that Citizen Action of Wisconsin presents with around the state. How the ACA impacts you and how to talk about it.
Nursing workforce diversity updates and anticipated trendsJulia Michaels
Presentation by Dr. Shanita D. Williams, PhD, MPH, APRN, Chief, Nursing Education and Practice Branch, Division of Nursing and Public Health, Bureau of Health Workforce, HRSA
Includes:
- Role of MA Department of Higher Education in workforce development presented by David Cedrone, Associate Commissioner for Economic and Workforce Development
- Update on Workforce Innovation and Opportunity Act (WIOA) state plan by Jennifer James, Director of Massachusetts Workforce Skills Cabinet
- Campus execution of Nursing Workforce Plan presented by Cloria Harris Cater, Associate Professor at Simmons College School of Nursing, Linda McKay, Professor and Chairperson of Department of Nursing at Fitchburg State University, and Ellen Santos, Director of Practical Nursing at Assabet Valley Regional Technical School
An Overview of the field of Nursing and outlook for the future. By Joanne Spetz, Ph.D.
Professor at the Philip R. Lee Institute of Health Policy Studies at the University of California San Francisco.
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
11 minutes agoJessica Dunne RE Discussion - Week 3COLLAPS.docxdrennanmicah
11 minutes ago
Jessica Dunne
RE: Discussion - Week 3
COLLAPSE
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population Health
INITIAL POST
Economic Challenges of Healthcare Policy
The economics of the healthcare system in the United States is complex and fragmented. Costs associated with care and the prices healthcare consumers pay are determined by a wide variety of factors making it extremely difficult to find a one size fits all solution. Knickman and Kovner (2015) argue that healthcare is neither a commodity or a service, because of the high variabilities in need, cost, and consumption. The United States spends 80% of all healthcare revenue on just 20% of the population. Health insurance can be provided by the government, the private sector, or an employer. Some citizens do not have any form of healthcare coverage. Regardless of type, insurance coverage generally only pays a portion of the total healthcare cost leaving the consumer to pay the remaining balance. Moreover, reimbursement standards differ for facilities and providers. The government reimburses healthcare facilities, such as hospitals a fixed amount per patient, which creates a higher incentive to work efficiently. Healthcare providers, on the other hand, are reimbursed based on a fee for service model, meaning the more services they provide, the more money they are reimbursed (Knickman & Kovner, 2015).
Reindart (2010) maintains the passage of the Affordable Care Act (ACA) created more strain on the system by adding approximately 30 million uninsured Americans to the market. The projected cost to provide such coverage is around 8 billion to 1 trillion dollars over the next decade. However, the estimated expense of healthcare with no legislative intervention is 35 trillion dollars over the next decade (Reindart, 2010). Laureate Education (2012) contends that the human resources required to provide healthcare to an additional 30 million people is another consideration the ACA does not address. The United States is already experiencing staff shortages for key healthcare jobs like nurses and physicians. Additionally, with baby boomers retiring from the workforce and simultaneously needing more healthcare resources as they age will inevitably exacerbate the shortage of providers (Laureate Education, 2012).
Ethical Considerations
It is important to recognize that the private sector often follows the public sector when deciding what services will be covered (Knickman & Kovner, 2015). Therefore, the implications of Medicare deciding not to pay for a drug or service will likely affect the entire population. Stein (2010) asserts that cost should not be a consideration in determining if medications or services will be paid for by Medicare. Nonetheless, that is what happened with Provenge, a vaccine indicated for late stage prostate cancer patients. The drug prolonged the lifespan of patients by about four months. Provenge costs around 93,000 dollars per p.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docxtoddr4
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docxhealdkathaleen
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu ...
Running head U.S. HEALTHCARE EXECUTIVES 1U.S. HEALTHCARE EX.docxjenkinsmandie
Running head: U.S. HEALTHCARE EXECUTIVES
1
U.S. HEALTHCARE EXECUTIVES
7
Week 2 Assignment-Operational challenges, trends and issues for the U.S. Healthcare Executives
Student’s Name
Institutional Affiliation
Introduction
A healthcare system is an organization of funds, individuals, and institutions which provide healthcare to satisfy the health requirements of a society. Globally, healthcare systems vary depending on the specific healthcare needs of particular states. Nevertheless, the common aspects of public and private care are often similar (Drummond, Sculpher, Claxton, Stoddart & Torrance, 2015). Over the years, we have witnessed the systems evolving, and with this constant change, it is vital to analyze operational challenges, trends, and issues for the U.S. healthcare executives. In this paper, the main areas that will be discussed are operational challenges, trends, and problems experienced in the United States health care executives.
Challenges experienced in the healthcare workplace
Various problems have been experienced in the healthcare workplace relating to healthcare provision in the United States. Financial difficulties are one of the main challenges being experienced in the healthcare workplace in the United States. The vital financial problems arise due to lack of enough finances for implementation of new technologies to improve healthcare delivery process (Mayes, 2017). Most healthcare facilities lack adequate funds to implement advanced technologies that can be used to increase the quality of healthcare delivery. As a result, this has reduced healthcare quality improvement plans in the United States. Therefore, there is a need for federal governments to meek proper arrangements to fund all healthcare activities to improve services delivery in the health sector.
Besides, healthcare professionals to comply with federal requirements for electronic health records is another challenge that has been experienced in the United States healthcare workplace. For the past year, some healthcare professionals have failed to comply with federal government guidelines regarding health care delivery (Mayes, 2017). Furthermore, the increasing number of patients who cannot pay for health care services is a significant challenge that has been experienced in the United States healthcare delivery systems. These finance challenges adversely affect healthcare delivery system in the United States.
Work overload is another major challenge that has been experienced in the United States health sectors (Mayes, 2017). Observations for past years reveal that work overload at the workplace affects the performance of health care professionals in the United States. Most healthcare professionals are assigned many responsibilities at workplaces, which reduces their efficiency.
Another cause of the rising cost of healthcare is the introduction of government programs. For example, Medicare assists those without insurance, which led to an incre.
Running Head HEALTHCARE STAKEHOLDER CONFLICTS1HEALTHCARE .docxcowinhelen
Running Head: HEALTHCARE STAKEHOLDER CONFLICTS
1
HEALTHCARE STAKEHOLDER CONFLICTS
5
Stakeholder Conflicts in Healthcare Visions
Kendra Smith
Grand Canyon University: HCA 675
Introduction
The stakeholders in the healthcare service in any jurisdiction entail the government, the healthcare providers or the physicians, the payers, the patients as well as healthcare professional organizations.
These stakeholders work hand in hand to ensure efficiency and professionalism in healthcare delivery (Blair et al, 1988). They do this by developing succinct policies and effectively implement them for the sole purpose of improving healthcare services. However, there have been serious conflicts in opinion regarding enhancing healthcare service practices and proper administrative mechanisms for the achievement of better services, among the stakeholders.
Conflicts in Health Vision
One of the major health reform visions which have generated considerable debate concerns the accommodation of evidence-driven healthcare service practice, which the government of the United States has instructed all healthcare service providers or organizations to adopt. The major emphasis on this aspect of medicine is the requirement by the government that all healthcare service providers or organizations should document which healthcare services they provide and why they provide such healthcare services to the communit
y.
The argument behind this requirement is that it will enable the government, or it will be generally helpful in gauging the benefits the community gains from such healthcare services. In addition, establishing evidence-driven healthcare practice according to healthcare practitioners will help in identifying specific health problems within a community, and subsequently, design the most appropriate medical response. Some healthcare stakeholders also believe that this is an avenue that the government intends to use in creating and forging a closer working relationship between private and public healthcare providers. However much most stakeholders, both private and public, appreciate this evidence-based healthcare practice, as a vital component in improving healthcare services, the major concern is about how such data should be obtained. Some healthcare providers have reasoned that these data should be generated from the already existing data, due to the costs associated with activities that may lead to acquiring and establishing sound data or information domain. In response to this requirement, most of the healthcare organizations have established community-based information or data collection and management mechanisms, which enable them to collect data concerning community health concerns and threats, then define effective ways of response.
With the introduction and implementation of a series of healthcare reforms in the United States, such as the Obamacare and Trumpcare, there is general expectation that there will be enhanced access to healthcare service ...
Student #2Reply with at least 500 words. Each thread must also i.docxflorriezhamphrey3065
Student #2
Reply with at least 500 words. Each thread must also include a biblical integration and at least 2 peer-reviewed source citations in current APA format.
In 2000, there were 7 million Americans that worked in health care (Thompson, 2018). In 2017, the rate of Americans working in health care almost doubled. (Thompson, 2018). Even in North Carolina, health care is 9.8% of the overall workforce (Kaiser Family Foundation, 2018). The increase of the health care work force can be attributed to the unstoppable growth in medical spending, and for the first time in history it has passed manufacturing and retail which was the most prominent source of employment in the 20th century (Thompson, 2018). Though there has been an increase in health care employment there is still a shortage of physicians and nurses. There are several contributing factors to the nursing shortage in the United States, such as education and the aging baby boomer population.
In America, experienced nurses are retiring at a rapid clip, and there aren't enough new nursing graduates to replenish the workforce. (Kavilanz, 2018). Nursing schools are experiencing an increase in applicants but these school do not have the capacity to increase their hiring rate. Robert Rosseter from the American Association of Colleges for Nursing says that this situation is catch 22 because there is a desperate need for nurses, but schools cannot fulfill this demand (Kavilanz, 2018). There are currently about three million nurses in the United States. The country will need to produce more than one million new registered nurses by 2022 to fulfill its health care needs" (Kavilanz, 2018). The need for more registered nurses grows but in 2017 over 56,000 qualified applicants were turned away from nursing school (Kavilanz, 2018).
The aging baby boomer population is another reason why the United States will need over one million nurses by 2022. According to the American Medical Student Association, the population of individuals over the age of 65 will increase by 73 percent between 2010 and 2030, meaning one in five Americans will be senior citizens. (Carrington College, 2014). The Alliance for Aging research has estimated that by 2030 over 33,000 geriatricians will be needed to accommodate for the growth of the elderly population. Not only will this senior citizen population need geriatricians they will also need nurses to help provide clinical care.
As a human resource manager in health care anticipating future need by using job analysis would be a great place to start when dealing with staffing shortages. It is important for human resource managers to research the cause of nursing shortages, so they are better equipped to prevent scarcity within their facility. The use of computerized human resources information systems will be helpful in recording these issues so that a clear and concise plan of action can be created (Pynes & Lombardi, 2011). Research suggests that experienced nurses are r.
April 2011In the fall of 2010, the Alliance for Health R.docxjewisonantone
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
April 2011In the fall of 2010, the Alliance for Health R.docxjustine1simpson78276
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my.docxjuliennehar
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my post. Hope this helps
Ryan,
Inadequate levels of nursing professionals were first discussed more than 80 years ago (Whelan, n.d.). Recently, scholars have opined many reasons for the shortage of nurses. Factors such as work stress, burnout, violence against healthcare professionals, a lack of qualified nursing instructors, and nurses unable to adapt to changing technology or clinical environments have been addressed (Haddad & Toney-Butler, 2019). As many nurses may attest, doing more with less can lead to mistakes and dissatisfaction with a nursing career. Ultimately, patient care suffers.
Organizations employ various tactics to help strengthen nurse retention. Halter et al. (2017) suggest strong nursing leadership and assigning preceptors to new nurses can help minimize nursing resignation rates. At the writer’s employment, hospital administrators use several ways to retain nurses. Each quarter, a nurse is recognized for outstanding achievement by receiving a certificate, gift card, and editorial mention on the hospital’s intranet. Moreover, the hospital caters lunch for all employees, dayside and nighttime staff, twice a year for meeting quality targets. Also, the hospital uses various national celebration days such as ice cream, donuts, coffee, bagels, and candy to reward all employees. Creating a level of goodwill and institutional collaboration can help retain nurses and improve job satisfaction (Kurnat-Thoma et al., 2017).
Reference
Haddad, L.M., & Toney-Butler, T.J. (2019). Nursing shortage. StatPearls Publishing.
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. https://doi.org/10.2174/1874434601711010108
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover: A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://doi.org/10.1177/2377960817697712
Whelan, J.C. (n.d.). Where did all the nurses go? Retrieved from https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technolo ...
Running Head THE NEED FOR APPROACHES TO IMPROVE CAUSE ADMINISTRA.docxaryan532920
Running Head: THE NEED FOR APPROACHES TO IMPROVE CAUSE ADMINISTRATION AND REPAYMENT IN THE HEALTHCARE SYSTEM
1
THE NEED FOR APPROACHES TO IMPROVE CAUSE ADMINISTRATION AND REPAYMENT IN THE HEALTHCARE SYSTEM
10
Title: The Need for Approaches to Improve Case Administration and Repayment in the Healthcare System
Abstract
The medical care system of the United States of America for the past years has been considered to be the most expensive in the world. The government of the United States has to spend huge amounts of money for medical care in relation to the gross domestic product and these sums are systematically increasing. Now many scholars came to the conclusion that it is the government programs, which held the responsibility for the growth of uncontrolled spending on medical care, with which such growth is a threat to the financial stability of the United States. The issue is worth-discussing, thus, the given work is devoted to the overview of the structure and the main issues of the US healthcare system to find the effective solution.
Unlike other developed countries the medical care system in the United States of America demands more and more funds while its quality remains the same. 1/3 of the US citizens are still uninsured and there is no future hope for improving the situation. People suffer from rapidly growing prices of medical services and slow growth of salaries inclement. Furthermore, the department of insurance loses its integrity and honesty; since they use such an opportunity to fraud money as well as not paying the workers. The risk of becoming bankrupt is very high in medical care system because of unplanned budget. The insurance programs, financed by the state, are also becoming more expensive, and the government is forced to pay more and more money, which later brings about increase in state financial expenditure that immensely contribute to the poor economy. Employees do not have the free will to change their job due to the high cost of insurance and the monopolization (Stone, et al., 2008,p.2-57). This paper will provide evidences by giving the most effective solution to control this problem and also encouraging people make decisive market decisions by finding new approaches.
There are many ways of handling this subject issue of “The Need for Approaches to Improve Case Administration and Repayment in the Healthcare System,” but this research paper primarily will focus on the five articles that represent scholarly articles concerning the subject issue on this topic. The five scholarly articles are: Nolin, (2015) in his study about “Jail overcrowding a perennial issue for many counties; (Stone, P., Hughes, R., & Dailey, M. 2008)about “Creating a safe and high-quality health care environment: Agency for Healthcare Research and Quality (US); U.S. Department of Health & Human Services (2014). New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings; Unit ...
HeadnoteGovernments with universal healthcare systems are increa.docxisaachwrensch
Headnote
Governments with universal healthcare systems are increasingly bemoaning the costs of their systems and the need to contain these costs if affordable healthcare services are to be sustained into the future. In a bid to reduce the costs of healthcare, politicians and bureaucrats have championed the need for reform. Although avoiding the language of rationing, the kinds of 'reforms' being championed (eg. greater government regulation of universal health coverage, reducing reimbursement for medical costs, cutting funding to public hospitals) seem however, to be more concerned with restricting universal healthcare coverage, rather than reforming it.
The rhetoric of healthcare reforms has also had a political ideological objective shifting the provision of and accountability for public healthcare services to private sector providers. This objective has been pursued despite experts warning that such a shift will ultimately lead (and in some cases has already led) to inequities and unjust disparities in access to healthcare and related health outcomes, especially in vulnerable populations who cannot afford private health insurance.
Australia has not been immune from ideologically driven machinations about the sustainability of its universal healthcare scheme, ie. Medicare. Despite health expenditure in Australia reportedly reaching a record low for the period 2012-2013, there has been a political campaign of spreading false and misleading information about Medicare's sustainability (Keast 2015).This misinformation has included 'blaming' vulnerable populations (eg. an ageing demographic, the 'undeserving poor') for their allegedly disproportionate over-utilisation of public healthcare services and the need to curb this costly 'wanton' demand. What has been overlooked in this situation, however, is that a key driver of the spiraling costs of healthcare is not the over-utilisation of services by people in need, but rather 'the use of wasteful tests and treatments' prescribed by doctors (Tilburt & Cassel, 2013) together with the rising costs of drugs (driven by the business behaviours of the pharmaceutical industry) and medical technology, particularly in hospitals. Also overlooked is the problem of language and the tendency to treat the terms 'healthcare', 'hospital care', and 'medical care' as being synonymous, when they are not. Failure to distinguish what each of these terms refers to unnecessarily muddles debate about what healthcare reforms are needed as well as where and how these should occur.
Question of nursing ethics
The ethics of healthcare rationing has been the subject of debate for decades. This debate has primarily rested on the issue of whether it is ever acceptable to ration healthcare and, if so, on what grounds. It has also prompted unresolved controversies about the interests of individuals versus the collective interests of society in accessing limited healthcare resources and how best to balance these competing inter.
1. Running head: THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 1
The Affordable Care Act: Funding for Primary Care Training and Implications for Practice
Jonathan D. Brouse
Maryville University
2. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 2
The Affordable Care Act: Funding for Primary Care Training and Implications for Practice
Introduction: The U.S. Primary Care Provider Shortage
Fundamentally, for the United States (U.S.) to build, implement, and sustain a high-
performing health care system envisioned by the Affordable Care Act (ACA), existing
provisions to bolster primary care provider supply must be fully funded and evaluated (Schwartz,
2011). Since its inception, the ACA has expanded health care access to millions in America,
thereby generating significant downstream impact upon demand of primary care physicians,
physician assistants (PAs) and nurse practitioners (NPs) alike (Allen et al., 2013). Nationally, an
expected shortage of 91,500 physicians is projected to occur by 2020 (Allen et al., 2013).
Meanwhile, Aiken (2011) noted that nursing programs have dismissed tens of thousands of
qualified applicants on account faculty shortage juxtaposed with budgetary constraints. Without
a dramatic increase to the US primary care workforce, cost containment, improved quality, and
enhanced provider access will not be achieved (Schwartz, 2011).
Although US Congressional efforts to dismantle or defund the ACA place the health
reform law at risk, the insidious threat of a primary care bottleneck exists (Schwartz, 2011).
Presently, the U.S. Health care delivery is plagued by a confluence of systemic challenges facing
the core of its primary care capabilities (Naylor & Kurtzman, 2010). Continued pressures
mounting from gaps in quality outcomes to increasing patient acuity, compounds concerns
regarding workforce adequacy in addition to resultant lags of quality (Naylor & Kurtzman,
2010). Likewise, health care consumption will be spurred by the impending “silver tsunami” of
80 million Americans retiring over the next two decades as expanded coverage is set to newly
integrate 32 million Americans (Schwartz, 2011). Finally, Naylor & Kurtzman (2010) note,
“Questions regarding the value of the primary care system, as evidenced by the performance on
3. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 3
numerous economic indicators, health outcomes, and multiple dimensions of patients’
experience, have been raised, especially in comparison to other developed countries” (p. 295).
Disregarding ACA provisions, it is expected that the primary care demand will increase
by 29% starting in 2005 and leading up to 2025 (Schwartz, 2011). Since 2011, 80 million baby
boomers joined the Medicare-eligible ranks, while this “silver tsunami” increasingly adds 10,000
per day through the year 2029 (Schwartz, 2011). Since 2002, medical schools have expanded
efforts to meet the projected need and have grown class sizes by 18%; yet, the shortfall continues
(Allen et al., 2013). Further, Naylor & Kurtzman (2010) underscores the point that, “gaps in
quality care accompanied by workforce shortage that threaten the provision of services” (p. 894).
Hence, the primary care shortage is likely to experience a perplexing bottleneck to realizing a
successful and optimal ACA implementation, resulting in millions of Americans disillusioned by
the unmet promise of system access despite coverage (Schwartz, 2011). Even with expanded
provisions to the 3P’s of primary care policy (pipeline, practice, and payment reform) within the
ACA, present funding and efficacious implementation remains susceptible unless greater strides
to rebuild the primary provider workforce occurs (Naylor & Kurtzman, 2010).
Affordable Care Act Provisions for Expanding Primary Healthcare Providers
On March 23, 2010, President Obama signed the historic legislation known as the Patient
Protection and Affordable Care Act (ACA), which represented the most profound transformation
of the U.S. healthcare system since the inception of Medicare and Medicaid (Manchikanti et al.,
2011). According to Allen et al., (2013), the ACA presents a new element to the pursuit of
expanding primary care provider supply. In meeting the envisioned goals of maximizing
efficiency, quality, and cost-containment, many hospitals throughout the U.S. are strategically
aligning into integrated health systems; yet, this alignment process entails assimilating physician
4. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 4
practices, which results in fewer independent physician practices and hospitals (Allen et al.,
2013). To that end, “some plan to become or align with accountable care organizations
(ACOs)—the defining organizational structure under the ACA, designed to reduce cost while
improving quality, safety, and efficiency” (p. 1862).
The ACA: Attending to the Primary Care Provider Shortage - Implications for Nursing
Granted the urgency to dramatically bolster the primary care workforce overall, greater
pecuniary support is required to expand the pipeline of primary care providers, including
advanced-practice registered nurses (APRNs) (Naylor & Kurtzman, 2010). To help ensure
sufficient primary care access as new coverage expands to millions of Americans, the ACA
provides significant investments that further expand the role of APRNs and PA’s alike (Paradise,
Dark, & Bitler, 2011). On September 27, 2010, the U.S. Department of Health and Human
Services (HHS) indicated that initial grant awards provisions
On the surface, the education of nurses may seem less pressing than ensuring care for
millions of Americans in a manner that is efficacious, safe, and affordable for all (Aiken, 2011).
However, Aiken (2011) cautioned that, “if we don’t alter the historical patterns of nursing
education, the country’s nursing resources will be crippled for the foreseeable future” (p. 196).
In underscoring the urgency of the faculty shortage, Aiken (2010) added, “Within the next 10
years, half of nursing-school faculty members will reach retirement age; the anticipated attrition
represents a crisis in the making, with potentially far-reaching consequences for the
replenishment of the nurse workforce, which is itself on the verge of losing some 500,000 nurses
to retirement” (p. 196). Fortunately, the ACA has begun to address the nurse faculty bottleneck
that precluded optimal enrollment of qualified students from entering into practitioner roles.
According to Naylor and Kurtzman (2010), the ACA provides relief in that, “it expands
5. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 5
eligibility criteria so that faculty at nursing schools qualify for loan repayment and scholarship
programs, and it establishes a federally funded student loan repayment program for nurses with
outstanding debt who pursue careers in nursing education” (p. 897).
Transforming health care for the advanced practice registered nurse (APRN) through the
political process begins with a focused approach upon emphasizing nursing education and
engaging the public in recognizing that nursing care provides an indelible component to quality
care outcomes (Tilden, 2010). Several important implications concerning the role of the
advanced practice nurse in shaping health care policy stem from the 2010 Institute of Medicine
(IOM) Report, The Future of Nursing, which calls for greater emphasis upon improved
curriculum to health policy education. According to the IOM report, a key lesson provided from
the past 2 decades is the degree to which “health systems and policy shape the health both of
populations and individual patients,” (Tilden, 2010, p. 559). Yet, few nursing students fully
appreciate the gravitas of health policy in its ability to not only affect nursing practice, yet, in the
end, direct patient outcomes (Tilden, 2010). Since nursing education curricula often exposes
students to little more than a token policy course, the resultant naiveté of nurse graduates
abounds, as with the perception that “nurses generally view themselves as being shaped by, not
shaping policy” (Tilden, 2010, p. 559).
When compared to the preeminent presence of medicine in driving legislative reform, it
has been well documented that nurses themselves often opt to a back seat policy approach
(Tilden, 2010). Later Tilden (2010) indicates that missed stakeholder opportunities to shape
policy are alarmingly common to the nursing profession. Nowhere is this more prominently
evidenced than within the Centers for Medicare and Medicaid Services (CMS) stipulation that
withholds reimbursement for “never events” (e.g., pressure ulcers, injuries, surgical site
6. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 6
infections, and catheter-related infections). Despite these conditions being preventable by means
of nursing intervention, the profession has yet to convince an American public or Congress, of its
vital importance to both the protection from and prevention of such health risks (Tilden, 2010).
In rectifying the “outgrowth of the inattention” facing nursing curricula to the matter of
health policy and the nursing profession, it is necessary to visit the recommendations placed
forth by the Health People Curriculum Task Force (Association for Prevention Treatment and
Research [APTR], 2014). This panel consisting of multi-disciplinary health specialties including
medicine, PAs, nursing, pharmacy, and representative educational associations contributed four
following domains quintessential to health policy curricula and instruction:
1. “Organization of clinical and public health systems (concerning the pieces of the
system; concerning clinical care to public health structures)”
2. “Health Services financing (underlying determinants of cost and options for payment
and cost containment; comparison to health systems of other countries)”
3. “Health workforce (understanding the roles and responsibilities of other health
professionals)”
4. “Health policy process (introduction to the impact of policy on health and clinical
care, the process involved in developing policies, and opportunities to participate in
those processes, whether within a local institution or state or federal legislation)”
(Allan et al., 2004).
As emphasized in the preceding points, adequate health policy curricula is needed at every level
of nursing education. Yet, at the graduate level, APN students “need to be actively involved in
political processes that affect the care they will deliver in the future” and therefore, educational
experiences should suffuse a hands-on approach along with explicative learning experiences
7. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 7
(Tilden, 2010, p. 561). To that end, an example curriculum objective for APN students includes
expecting students to demonstrate the link between evidence and policy (i.e., discerning the role
APNs perform in illuminating practice issues and garnering attention of policy creators).
Finally, interprofessional groups can collaboratively engage students together in directing policy
projects (Tilden, 2010).
Pros and Cons of the ACA Legislative Provisions in Addressing Primary Care Shortage
Commentary - Scope of Problem and Fulfilling the Promise of Improved Primary Care
First and foremost, sustaining meaningful efforts to drive ACA’s patient-directed goals of
effective, accessible, quality-outcomes based care rests upon ensuring an expanded pipeline to
primary care practitioners (Jacobson & Jazowski, 2011). Doing so relies in part upon channeling
public funding for nurse education in order to steer change in healthcare delivery according to
the IOM’s recommendations (i.e., streamlining efficient pathways to obtain further advanced
education after initial licensure) as this will lead to greater potential for optimal outcomes
(Institute of Medicine [IOM], 2011).
Furthermore, a combination of financial resources via public and policy-driven initiatives
to expand
Conclusion
Great strides to nursing education are required, from inclusion of greater health policy
curricula to producing graduates with requisite nursing acumen to practice safely and effectively.
While there will be inherent challenges to adapting entrenched paradigms to nursing curriculum
and instruction, it is possible to create inroads to existing models of nursing education (APTR,
2014). By structuring content around knowledge, related competencies including policy-related
8. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 8
learning opportunities, students can master requisite legislative techniques to play important
policy stakeholders in order to influence both practice and ultimately, patient care outcomes
(Tilden, 2010).
9. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 9
References
Aiken, L. H. (2011, January 20). Nurses for the future. The New England Journal of Medicine,
364, 196-198. http://dx.doi.org/10.1056/NEJMp1011639
Allan, J., Barwick, T. A., Cashman, S., Cawley, J. F., Day, C., Douglass, C. W., ... Wood, D.
(2004). Clinical prevention and population health curriculum framework for health
professionals. American Journal of Preventive Medicine, 27, 417-422.
http://dx.doi.org/doi:10.1016/j.amepre.2004.08.010
Allen, S. M., Ballweg, R. A., Cosgrove, E. M., Engle, K. A., Robinson, L. R., Rosenblatt, R. A.,
... Wenrich, M. D. (2013, December 01). Challenges and opportunities in building a
sustainable rural primary care workforce in alignment with the Affordable Care Act: The
WWAMI Program as a case study. Academic Medicine, 88, 1862-1869.
http://dx.doi.org/10.1097/ACM.0000000000000008
Andrulis, D. P., Siddiqui, N. J., Purtle, J. P., & Duchon, L. (2010). Patient Protection and
Affordable Care Act of 2010: Advancing health equity for racially and ethnically diverse
populations [Report]. Retrieved from
http://jointcenter.org/sites/default/files/Patient%20Protection%20and%20Affordable%20
Care%20Act.pdf
Association for Prevention Treatment and Research. (2014). Clinical prevention and population
health curriculum framework. Retrieved February 14, 2015, from
http://www.aptrweb.org/?CPPH_Framework
Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011, January 20). Broadening the
scope of nursing practice. The New England Journal of Medicine, 364, 193-196.
http://dx.doi.org/10.1056/NEJMp1012121
10. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 10
Hertz, B. T. (2013, February 25). How the ACA is reshaping medicine. Improvements in
compensation, payer collaboration offset by provider shortages, incentive uncertainty.
Medical Economics, 90, 30, 32, 39. Retrieved from
http://eds.a.ebscohost.com.proxy.library.maryville.edu/ehost/pdfviewer/pdfviewer?sid=4
aef7051-60d4-4e83-af6b-dc396d723bb5%40sessionmgr4004&vid=29&hid=4208
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health.
Washington, DC: The National Academies Press.
Jacobson, P. D., & Jazowski, S. A. (2011, August 1). Physicians, the Affordable Care Act, and
primary care: Disruptive change or business as usual? Journal of General Internal
Medicine, 26, 934-937. http://dx.doi.org/10.1007/s11606-011-1695-8
Kaiser Family Foundation. (2012). Disparities in health and health care: Five key questions and
answers [Issue brief]. Retrieved from http://kff.org/disparities-policy/issue-
brief/disparities-in-health-and-health-care-five-key-questions-and-answers/
Kaiser Family Foundation. (2013). Summary of the Affordable Care Act [Fact sheet]. Retrieved
from http://kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/
Lesko, S., Fitch, W., & Pauwels, J. (2011, September). Ten-year trends in the financing of family
medicine training programs: Considerations for planning and policy. Family Medicine,
43, 543-550. Retrieved from
http://www.stfm.org/fmhub/fm2011/September/Sarah543.pdf
Manchikanti, L., Caraway, D., Parr, A. T., Fellows, B., & Hirsch, J. A. (2011). Patient Protection
and Affordable Care Act of 2010: Reforming the health care reform for the new decade.
Journal of the American Society of Interventional Pain Physicians, 14, E35-E67.
11. THE AFFORDABLE CARE ACT: FUNDING FOR PRIMARY CARE 11
Retrieved from http://www.painphysicianjournal.com/2011/january/2011;14;E35-
E67.pdf
Naylor, M. D., & Kurtzman, E. T. (2010). The role of nurse practitioners in reinventing primary
care. Health Affairs, 29, 893-899. http://dx.doi.org/10.1377/hlthaf.2010.0440
Paradise, J., Dark, C., & Bitler, N. (2011). Improving access to adult primary care in Medicaid:
Exploring the potential role of nurse practitioners and physician assistants [Issue brief].
Retrieved from https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8167.pdf
Schwartz, M. D. (2011, November 1). Health care reform and the primary care workforce
bottleneck. Journal of General Internal Medicine, 27, 469-472.
http://dx.doi.org/10.1007/s11606-011-1921-4
Tilden, V. (2010). The future of nursing education [Policy brief]. Retrieved from Institute of
Medicine website: http://www.iom.edu/reports/2010/the-future-of-nursing-leading-
change-advancing-health.aspx
Zweifler, J., Prado, K., & Metchnikoff, C. (2011, February). Creating an effective and efficient
publicly sponsored health care delivery system. Journal of Health Care for the Poor and
Underserved, 22, 311-319. Retrieved from
http://search.proquest.com.proxy.library.maryville.edu/docview/856207489/fulltextPDF?
accountid=40561