Healthcare Delivery System

Healthcare Delivery System

There is a rapid change within the healthcare system in the United States. The

changes that have occurred were made for the purpose of improving quality,

rewarding value and not volume, as well as integrating and coordinating the care

(Seshamani & Sen, 2018). As such, this paper will seek to put into consideration

current healthcare laws within the U.S. and the nurse’s role within this continuously

changing environment; the manner in which quality measures and pay for performance

affect patient outcomes. Furthermore, the emerging trends in the healthcare system,

professional nursing leadership, and management roles will be discussed. Healthcare Delivery System

The Emerging Health Care Laws and their Effects on Nursing Practice

One of the most crucial healthcare legislat ions that has been enacted in the United

States since the inception of Medicare and Medicaid in 1965 is the Affordable Care

Act (Obama, 2016). The ACA was enacted in 2010. Issues relat ing to affordability,

ease of access, and the care quality within the United States healthcare system were

some of the driving factors that formed the list of many t ime spanning challenges

that compiled the init iat ion of this legislat ion. Between 2010 to 2015 there was a

decrease in the number of uninsured cit izens in the U.S. by forty three percent as an

effect of the Affordable Care Act. Healthcare Delivery System

The payment systems in healthcare are undergoing some changes and the access to

care has also improved (Obama, 2016). The ACA promotes preventive healthcare

models that put emphasis on quality care, primary care, and the funding of community

health init iat ives (Lathrop and Hodnicki, 2014). Millions of previously uninsured cit izens

are also provided insurance coverage and also some healthcare areas that need

reforms so as to meet the needs of patients’ improved healthcare outcomes are

highly focused by the act. The act has an effect on nursing practice in several ways.

The first effect is that the act creates a high demand for healthcare professionals

that are sufficiently trained to provide healthcare services that are up to the acts’

standards. The second effect is that Advanced Practice Registered Nurses (APRNs)

who hold the Doctor of Nursing Practice (DNP) are required to be prepared so that

they can meet the increased needs through the provision of leadership skills in

community health centers. These professionals are also held accountable for direct ing

and advocating for future init iates as well as serving on interdisciplinary teams. Healthcare Delivery System

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Pay for Performance and Quality Measures effects on the outcome of Patients

Pay for Performance is used to describe value-based payments. It consists of

payment models that accompany financial benefits to the performance of the

provider. The main object ive of pay for performance is to convert healthcare to value

based medicine. In addit ion to that, it encourages health care providers toward care

that is value-based since it connects reimbursements to metric-driven outcomes. Healthcare Delivery System

Furthermore, it helps to promote patient sat isfact ion and best practices thus,

support ing payment with quality and value. The reason pay for performance was

introduced was for the purpose of ensuring there is improvement of the quality of

healthcare and the experience of patients. This is achieved by ensuring the healthcare

facilit ies accept practice and enforce the outlined healthcare best practices and

ensure the customer satisfact ion rat ings are high. Hospitals are usually reimbursed

based of their performance on a set of standardized domains of quality that are

reduction of cost, their efficiency, safety, clinical care, and the experience that is

centered on the caregiver. (, 2018). This means that the expected

actions of the nurses are to ensure that they adhere to the specified safety


measures while offering their services to patients. They should also provide efficient

services and adequate clinical care. Healthcare Delivery System

Arisen Professional Nursing Leadership and Management Roles

Nursing as a service field is vibrant and challenging as it continuously requires leaders

and role models to engage and inspire the other upcoming nurses (Scully, 2015).

Therefore, there is a need to identify and develop leaders in the nursing profession so

that they can they can provide the leadership, inspirat ion and engagement that arise

from the emergent trends as well as be part of the frontrunners that promote quality

patient care Healthcare Delivery System

Among the roles that have evolved to a higher calling are leadership competences.

For the purpose of promoting patient safety and quality care strong leadership skills

are required for all levels of nursing. Partnership as a nursing leadership style is

paramount. It encourages the nurses to work with colleagues fully as partners through

collaboration. This plays the role in improving patient outcomes, reducing medical

errors and promoting employee retention. Addit ionally, it discourages workplace

bullying and other disruptive behaviors that continue to disrupt the healthcare

industry. Healthcare Delivery System

Healthcare Emergent Trends

One of the emergent trends in healthcare is that there have been changes in roles of

the c-suit in the hospital. The adoption of machine learning in predict ing and treating

condit ions will encourage and enable many healthcare facilit ies to create new

posit ions such as the innovation chief, and data analyt ics officers. These posit ions will

be crucial as organizations embrace technological init iat ives. Innovations and

init iat ives such as these will enable the hospitals to lower their operational and other

costs and also improve the patient’s experiences. The other posit ion that would be

essential is the Chief Nursing Informatics Officer (CNIO) due to the widespread

adoption of technology. Another emergent trend concerning the spending on

spending. Therefore, healthcare facilit ies will focus on saving costa spent on drugs. Healthcare Delivery System

This is because out of the eighteen percent of the United States gross domestic

product (GDP) consumed by health care, seventeen percent of it is spent on

prescript ion drugs. Therefore, data driven providers can reduce costs by deploying

means to track the spending on drugs with clinical outcomes.

The nursing practice and nursing roles would metamorphosize in the near future years

in order to respond the upcoming trends. One change that is likely to be experienced

is the intensified demand for nurses that are highly skilled. Nurses shortages will bring

about the need for hospitals to provide continuous sufficient training to fresh nurses

that are joining the industry. Healthcare Delivery System


Lathrop, B., & Hodnicki, D. (2014). The Affordable Care Act: Primary Care and the

Doctor Healthcare Delivery System

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