NRS-440 Topic 1 DQ 2:EXPLAIN HOW HEALTH CARE REFORM HAS HELPED SHIFT THE FOCUS FROM A DISEASE-ORIENTED HEALTH CARE SYSTEM TO ONE OF WELLNESS AND PREVENTION
NRS-440 Topic 1 DQ 2:EXPLAIN HOW HEALTH CARE REFORM HAS HELPED SHIFT THE FOCUS FROM A DISEASE-ORIENTED HEALTH CARE SYSTEM TO ONE OF WELLNESS AND PREVENTION
Topic 1 DQ 2
Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place.
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The Centers for Medicare and Medicaid Services (CMS) have shifted from traditional fee for service into value base purchasing with the enactment of Affordable Care Act (ACA) (Walker et al., 2022). Healthcare providers (hospitals, nursing homes, and home health agencies) are now part of this value-based purchasing contract where patients admitted should be kept out of the hospital for at least thirty days for them to get reimbursement. If a patient gets readmitted for the same reason, especially with CHF diagnosis, the provider will not be paid for the patient’s readmission.
Nurses play a huge role in keeping the patients out of the hospital. In the homehealth setting, nurses can provide education and health promotions such as medication compliance and front-loading visits to ensure the patient is closely monitored within the next two weeks of admission and ensure remains within baseline and out of the hospital.
Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2022). The effect of the Affordable Care Act on Medicaid payments in long-term care facilities. International Journal of Healthcare Management, 15(1), 62–69. https://doi-org.lopes.idm.oclc.org/10.1080/20479700.2020.1843886
GP
Gregory Pryor
Jul 30, 2022, 3:49 PM
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Replies to Joseph Lagman
Hello Classmates,
Healthcare reform is often associated with the affordable care act(ACA). Although ACA may top the list of healthcare reforms, the list is much more extensive. Quality of care, health care cost, re-engineering insurance options, innovative technological advances, pharmaceutical cost, and improved approaches to treatment and overall healthcare sustainability.
Access to healthcare for every one is of the most critical reform that must be conquered. Until everyone can receive adequate, fair, care and disparities are minimized, will healthcare equity be obtained(Shi & Stevens, 2021). Healthcare cost is one of the largest expenditures of the GDP. Though cost has continued to increase year after, there are signs that the technology and medical advancements have improved. The question asked is just how much more will it cost? The cost has to be contained. It’s not the amount spent, but are we getting the worth of our spending? Quality of care must improve by investing in research that proves to be evidence-based in practice will allow health care providers to make better choices and practice with confidence and continuity.
How does nursing fit into this puzzle? Nurses are the largest percentage of the workforce providing care. The government must invest in the profession and science of nursing. Nurses must be allowed to practice to the full extent of their knowledge and training. Advanced nurse practitioners are filling the shortage of physicians and should be allowed to practice with full autonomy and with the same respect as physicians including equal pay for the same care that is being provided according to the scope of practice(Brom, Salsberry & Graham, 2018).
As for the professional baccalaureate-prepared nurse, care has been reformed from an illness to wellness continuum to a continuum of wellness to preventing illness and prevent further deterioration of the health status. How is this accomplished? Through the promotions of healthcare that address the three levels of prevention( primary, secondary, and tertiary). The primary focus is on preventing disease, the secondary focus is on screening and diagnosing, and the tertiary focus is on stabilizing and preventing further deterioration of the health status(Kisling & Das, 2021).
Reference
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120.
Kisling, L. A., & Das, J. M. (2021). Prevention strategies. In StatPearls [Internet]. StatPearls Publishing.
Shi, L., & Stevens, G. D. (2021). Vulnerable populations in the United States. John Wiley & Sons.
- MB
Melisha Burns
replied toGregory Pryor
Jul 31, 2022, 10:21 AM
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Replies to Gregory Pryor
You make a valid point. Not only is there a shortage of nurses, but there is also a shortage of physicians. Studies show that patients living in rural areas are five times more likely to live in a county with a physician shortage than those living in urban or suburban areas. Studies also indicate a potential primary care physician shortage of between 14,800-49,300 physicians by 2030. With these shortages, there has to be health care providers to take care of patients in these areas. This is where nurse practitioners are filling the void. We have rural counties in our area where there is one primary care physician, and the rest of the health care needs are taken care of by nurse practitioners. They are able to provide the care the community members need and promote positive health promotion measures within the area.
- MM
Mary Kate Morrisette
replied toGregory Pryor
Jul 31, 2022, 10:08 PM
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Replies to Gregory Pryor
I like that you also tied in the three stages of prevention and health promotion, as prevention extends even beyond the diagnosis of the disease. One important part of prevention across all of the stages is education, which is a vital aspect of the nursing role. Health education plays a vital role in health promotion and preventing disease (Whitehead, 2018).
We can educate people on modifying their risk factors and making lifestyle changes that will improve their health and prevent disease. For example, diet and exercise are major modifiable risk factors in so many diseases. If we can put more emphasis on educating the public about living an active lifestyle and eating a healthy diet, this could have a significant impact on their health and wellness, rather than waiting until after they already are faced with illness or disease.
Reference
Whitehead D. (2018). Exploring health promotion and health education in nursing. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 10.7748/ns.2018.e11220. Advance online publication. https://doi.org/10.7748/ns.2018.e11220
Greater coordination of care across providers and across settings will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department, utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions and adverse drug interactions (Salmond et al.,2017). Nurses who are well informed of health trends will be positioned to interpret their impact on health and better prepared to provide individual and systems level interventions to improve the health of communities. Nurse leaders will need to develop a multilevel approach that focuses on the nurse, the team and the organization to address trends to address disease-oriented health care goals.
The Affordable Care Act recognized a principle by exempting a list of primary and secondary preventive services from copays and deductibles (Dolan, 2018). Hopefully new trends in healthcare will continue to seek ways to prevent conditions that negatively impact patients. With the support of the health care reform, clinicians can treat more patients with poor lifestyle choices and provide better access to immunizations and medications. Interventions to reduce health disparities associated with social class in the future will likely result from policy efforts directed at the entire population to support wellness. Nurses will always support new trends for health promotion and disease prevention measures to engage patients to choose risk-reducing behaviors.
Reference:
Dolan, E. (2018). The Role of Prevention in Health Care Reform. Commentary Health Care. Niskanen Center.