Affordable Care Act: Public Health and Nursing

The Role of the ACA in Population Health Promotion

The Affordable Care Act (ACA) was introduced on March 23, 2010, to provide access to health care for people who could not afford insurance due to a low level of income. The impact of ACA is hard to overestimate: The role of public health has gained unprecedented significance, which has led to dramatic transformations of health care practices in all aspects, including offered services, funding, quality of care, technological provision, etc. (Miller, Frogner, Saganic, Cole, & Rosenblatt, 2016).

Therefore, it can be stated that the ACA has produced a direct impact on the whole health care industry through the establishment of Public Health Fund (providing obligatory financing to communities) and the development of the National Prevention Strategy (identifying and addressing factors that determine population health) (Sommers, Buchmueller, Decker, Carey, & Kronick, 2013).

Besides pursuing its ultimate objective of improving access to medical services through the expansion of insurance options, the ACA also fostered other practices that are important for population health, such as disease vaccinations and screening. More and more people are provided with an opportunity to use preventive services free of charge (such as blood pressure measuring, cholesterol screening, cancer examination, and immunizations services) (Antwi, Moriya, & Simon, 2015).

Furthermore, legal compliance obligations of health care specialists have also increased, which means that the current demands to quality have become much harder to satisfy. This accounts for the fact that the number of physicians decreased considerably as a lot of private practices were closed, being unable to meet the new standards (Miller et al., 2016).

Expected Changes in Health Care and Nursing Profession

Although the industry of health care has already undergone considerable transformations, the major changes are still to come. They may include:

  1. An increased number of patients: Since the generation of baby boomers will soon reach the age of 65-70, it means that more cases of heart disease, diabetes, and age-related conditions will have to be handled (this will also increase the workload of all nurses in general and RN Case Managers in particular) (Bhattacharjee & Ray, 2014).
  2. More technology: With the use of modern technologies and screening tools (e.g., magnetic resonance, positron emission tomography, computer diagnostics, etc.), treatment is to become less invasive. The risk assessment will be performed with DNA chips, while CPT code will be created automatically by advanced software allowing physicians to analyze patient records. These innovations could be partially financed by the government to bring the industry to a new level (Farmer, 2013).
  3. Higher accountability: Hospitals are already punished when their performance indicators are low (for instance, Hospital Readmissions Reduction Program (HRRP) presupposes penalties for increased readmission rates), and the level of accountability will increase, which will affect all health care specialists. This initiative will be promoted and financed by the government to improve the quality of care (Farmer, 2013).
  4. Shift from treatment to prevention: Health care will be focused on keeping the population healthy to minimize the need for treatment. This is especially significant for nurses as their practice will be more concerned with educating patients and promoting prevention strategies: e.g., informing about negative impacts of tobacco, alcohol, and drugs, teaching healthy dieting, communicating the importance of physical activities, etc. The initiative will be funded both by the government and private companies interested in promoting their healthy products (Chism, 2015).
  5. Greater role of the Internet: Electronic medical record system is already widely implemented in several hospitals, and its scope of application is going to increase. For example, it will be able not only to store and organize patients’ data but also to use statistical analysis and perform clinical research of similar cases to immediately provide several best-practice solutions (Bhattacharjee & Ray, 2014). This will significantly facilitate the work of nurses (especially in my area of practice), also because self-diagnosis and self-care practices will increase due to online databases (Chism, 2015). There will be less need for home visits as video surveillance will gain popularity. However, the development of such technologies will require private investments as the government is unlikely to finance non-obligatory improvements.

The Role of Nurses in Integrating Healthcare and Prevention

It would be wrong to state that nursing roles will be changed drastically with the described changes as nurses will continue to be among the major health care providers in all areas even though some of their functions will become unnecessary or will be performed by machines. Nevertheless, registered nurses will still influence the population health, delivering high-quality care, ensuring patient safety, providing patient and family education on treatment and prevention measures, implementing follow-up plans, etc. Yet, the focus of their practices is sure to be shifted to preventing diseases and disseminating information in various communities (Chism, 2015).

This change in focusing will require reviewing the curriculum of nursing educational institutions as they are currently oriented to provide care to patients already suffering from some health conditions. Now, schools of nursing are not ready to prepare specialists that will be able to follow all new trends. Nurses are not taught to use the latest technologies or provide remote care. Moreover, too little information is given on preventive measures that can be expanded with the opportunities offered by the Internet (Chism, 2015).

References

Antwi, Y. A., Moriya, A. S., & Simon, K. I. (2015). Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate. Journal of health economics, 39(3), 171-187.

Bhattacharjee, P., & Ray, P. K. (2014). Patient flow modelling and performance analysis of healthcare delivery processes in hospitals: A review and reflections. Computers & Industrial Engineering, 78(1), 299-312.

Chism, L. A. (2015). The doctor of nursing practice. Burlington, MA: Jones & Bartlett Publishers.

Farmer, P. E. (2013). Chronic infectious disease and the future of health care delivery. New England Journal of Medicine, 369(25), 2424-2436.

Miller, S. C., Frogner, B. K., Saganic, L. M., Cole, A. M., & Rosenblatt, R. (2016). Affordable care act impact on community health center staffing and enrollment: A cross-sectional study. The Journal of Ambulatory Care Management, 39(4), 299-307.

Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., & Kronick, R. (2013). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Affairs, 32(1), 165-174.