Affordable Care Act and Delivery System Reforms

Select one of the healthcare mandates, the Affordable Care Act or the American Health Care Act, and identify what are the specific provisions within the mandate that will directly impact the delivery and type or method of care you give to your patients. Discuss one key challenge that you anticipate facing in advanced practice as a result of one of the provisions of your selected mandate.

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The Affordable Care Act (ACA) has numerous provisions regarding the delivery of health care, one of the most important of which is the Hospital Value-Based Purchasing Program (HVBP). According to this provision, care providers are expected to provide high-value care instead of a high-volume one (“The Affordable Care Act’s payment,” 2015). The mentioned provision concerns only in-patient services, including acute care hospitals and focuses on quality data collected directly from the organization. Mortality and complications, patient experience, efficiency and cost reduction, and patient safety compose the criteria for HVBP.

As noted by Commonwealth, “policy recommendations include improving quality measures and accounting for socioeconomic factors to prevent the policy from widening current health disparities” (“The Affordable Care Act’s payment,” 2015, para. 22). HVBP enacts measures to eliminate any errors and gaps and to improve patients’ experiences during their stay at the hospital. This provision directly influences a severity diagnosis-related group (MS-DRG) and establishes a holistic and transparent method of care. Promoting evidence-based care standards, HVBP contributes to the provision of the best care possible through achieving improved health outcomes.

The key challenge that seems to occur as a result of the above provision of ACA is how to keep focused on high quality when care standards are changing rapidly. Taking into account the inevitable delay between research studies, their publication, dissemination, and implementation, it may become rather difficult for nurses to remain aware of the latest requirements regarding care quality. The clinical guidelines should be adjusted in a timely manner to prevent misunderstanding, as noted by Chee, Ryan, Wasfy, and Borden (2016). Thus, the main challenge is associated with the timely delivery of care standards to nurses as well as their thorough development and dissemination.

Select the state where you plan to work as an advanced practice nurse (Florida) and investigate the state’s policies on access to contraception and abortion for women with insurance and those without. What are the state’s infant and maternal mortality rates? Discuss the possible relationship between these factors. Address how as an advanced practice nurse and nursing leader, one can influence a desired change in the current health policies. Be sure to identify one MSN Essential that most relate to this topic in your discussions.

In Florida, women having insurance may be offered abortion only in case there is some threat to their life or in case of rape or incest. According to the policy of the state, any other reason for abortion requires the additional payment for services. As for those women who are not covered by insurance programs, they should pay out of pocket. However, they may refer to the local clinics and funds to seek financial help or a small discount.

The national funding networks may also help in some cases. Public funds are available only in the event of rape, life endangerment, or incest. Every woman in the state has an inherent right to access medically acceptable contraceptive procedures and receive the corresponding information (“The 2017 Florida Statutes,” 2017). In 2014, 75,990 abortions were performed in Florida which is equal to 8.2 of those conducted in the US (“State facts,” 2015). The state’s infant and maternal mortality rates are 5 and 16.9 per 100,000 live births, respectively.

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It seems that the risk of unintended pregnancy and the subsequent abortion rates would be reduced in case of some change in the state’s policies. The research shows that many economic and social challenges force women to choose this procedure.

As an advanced practice nurse, it is important to suggest new policies and promote better access to abortion and contraception in Florida. For example, working in a family planning center, it is possible to provide contraceptive and abortion services based on public funding. Considering that the majority of abortions result from unintended pregnancy, it is critical to adjust policies regarding women’s awareness. MSN Essential of Health Policy and Advocacy should be applied in this case.

References

Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current state of value-based purchasing programs. Circulation, 133(22), 2197-2205.

State facts about unintended pregnancy: Florida. (2015). Web.

The 2017 Florida Statutes. (2017). Web.

The Affordable Care Act’s payment and delivery system reforms: A progress report at five years. (2015). Web.

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