Health Care Delivery Models and Nursing Practice

Health Care Delivery Models and Nursing Practice


A few factors driving change in healthcare are unsatisfactory results, access problems, fragmentation, disparities, and unaffordable costs. Reform was spurred by worries about quality and cost as well as changing socioeconomic and disease demographics.

Health Care Delivery Models and Nursing Practice

The cost of managing chronic illnesses is a significant issue. Greater care coordination between providers and locations benefits quality, outcomes, and costs by reducing unnecessary hospital admissions, adverse medication interactions, repeating medical history, repeated diagnostic tests, multiple prescriptions, and unnecessary emergency department usage (Cleveland et al., 2019). The US has been steadily raising the standard of living and lowering costs for decades.

Caregivers are in a prime position to contribute to and lead revolutionary changes in healthcare due to the shift from a provider-based, episodic, fee-for-service system to one that is team-based (Harris et al., 2019). These modifications have been influenced by regulatory changes and a total overhaul of the nursing system.

This research explores how evolving nursing trends and their effects on nurses’ duties and obligations have been impacted by federal regulations, health care reform, and evolving nursing trends.

Federal Regulation and Health Care Law

In 2010, the Patient Protection and Affordable Care Act (ACA) was passed in response to the 50 million uninsured and 40 million underinsured Americans living in the United States (S G, 2020). The ACA includes value-based initiatives, which are now overseen by the CMS and aim to improve care quality and contain costs. These programs go beyond insurance reform and enhance accessibility for newly covered people (Cleveland et al., 2019).

Value is essentially a ratio, with cost as the denominator and results and high-quality treatment as the numerator (S G, 2020). Improving value includes keeping people healthy, emphasizing quality over quantity, and creating the health information technology infrastructure required to support novel payment and delivery methods.

The Hospital-Acquired Condition Reduction Program, which had existed before the Affordable Care Act but was formally established under it to broaden the list of undesirable conditions, is now in operation. For high quartile scores with poor HAC rates, sanctions are used (Cleveland et al., 2019).

These relatively avoidable illnesses, which were absent when the patient was brought to the hospital, must be monitored and reported. The use of evidence-based procedures has reduced these rates, the development of checklists to ensure protocols are followed, and the expeditious discharge of patients from EDs and ICUs.

Certain spine and total hip and knee arthroplasty procedures are covered through bundled payments, which compensate many providers for a single episode of care over a set period. A fully integrated payment system covers the hospital, the surgeons, and all other healthcare professionals involved in the patient’s care before, during, and after the procedure (Cleveland et al., 2019)

Combining two or more payments into one is the practice of bundling. Bundles dismantle current payment silos to help healthcare eliminate duplication and waste, boost efficiency, use evidence-based practices to improve results, and include patients in developing their own capacity for treatment (Cleveland et al., 2019). The most common inpatient surgical treatments for Medicare, such as knee and hip replacements, are made better in terms of quality and effectiveness through the Comprehensive Care for Joint Replacement concept.

The desire for an inexpensive, safe, accessible, patient-centered care system and healthcare reforms both heavily include nursing. All nurses, from the CNO to the lower-level nurses, should be aware of how drastically changing nursing practice is necessary to achieve these goals (Harris et al., 2019). To handle these advances, a new or improved set of wellness and population care abilities will be required.

Transformation and change at the individual and systemic levels are challenging to accomplish. Each nurse must evaluate their skills, knowledge, and attitudes to see if they promote or obstruct improvement. It requires research into the organization’s purpose, objectives, relationships, procedures, leadership, and other crucial elements, upending the status quo (Harris et al., 2019). People must adapt to their specific circumstances since the roles of patients, doctors, nurses, and other healthcare professionals are evolving.

Quality Measures and Their Effect on Nursing Practice

A “pay for performance” system rewards healthcare professionals according to how well they execute their jobs. It is a system of performance-based compensation created to enhance patient care. This paradigm, therefore, penalizes practitioners for subpar performance. For instance, a psychologist who cannot assist a patient in quitting smoking will not be compensated.

By encouraging doctors and nurses to give excellent patient care to receive the financial rewards connected with their jobs and performance standards, this idea enhances the quality of medical results. If this reward system drives patient dumping, it could result in poor patient outcomes. Physicians prefer to focus on cases that are likely to win to earn their awards and incentives (Kyeremateng et al., 2019). Patients are harmed by this method because those in the periphery do not receive timely and proper medical attention.

Nursing Management and Leadership Roles

The chief coordinator, nurse leader, and advanced registered nurse now have more duties as a result of the ACA. Predicting how development and education will relate to job requirements is challenging due to the speed of reforms. The implementation of a uniform framework for purposeful leadership development across the continuum of care is one change in nurse leadership and management duties (Cleveland et al., 2019).

Key elements that might enhance clinical leadership development and education include innovation and professional interdependence. The development of knowledge, abilities, and capacities for implementing adjustments and creative solutions at the point of care is another responsibility of management (Harris et al., 2019). Nurse leaders must support the digital literacy of their nursing team. The nurse manager and leader will ensure the nursing staff’s access to technical training. Nurses, as a result, enhance patient care and security.

Emerging Trends

In the field of medicine, telemedicine is a new idea. With the development of technology, telemedicine is growing in popularity. Nurses’ jobs will alter as a result of telemedicine. Since patients may contact nurses via telehealth systems, telemedicine will improve the nurse’s ability to communicate.

The nurse should develop their communication skills by using precise language, speaking with their patient as soon as possible, and communicating effectively so they can attend to other patients because patient involvement no longer takes place in person. The way nurses treat patients is also influenced by telemedicine. Nurses will need to learn more about technology and how to use the internet to communicate with patients, just as medical and surgical robots.

Problems with telemedicine technology that might be harmful to patients’ health must be avoided by the nurse. As a result, there is a growing dependence on technology in the nurse’s function. Nursing leadership jobs are increasingly utilizing technology and nursing informatics (Harris et al., 2019). The use of technology in healthcare is a growing trend, thus, nurses must learn and hone their technological skills. For instance, surgical robots are used in surgery, thus, surgical nurses need to be knowledgeable about the tools in order to do their tasks properly.


Evidently, the nursing workforce is growing more diverse and educated due to recent improvements in nursing practice. This is great for patient care, but it challenges nurses seeking professional progression. Nurses have gone from doctor’s handmaiden to healthcare partners. As esteem for nursing grows, so have duties, expectations, and leadership positions for advanced-degree nurses.

As nursing duties and functions expand and demand for nurses rises, assessing a community’s health is becoming a new skill. This holistic approach to body, mind, and community health is becoming vital to nursing patient care. The American Nurse Association calls these efforts fostering a culture of health and has developed various initiatives to promote it as one of the most crucial future developments in nursing. Technology advancements will transform patient care and nursing education. Automation, mobility, and remote care continue to transform nursing.


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Health Care Delivery Models and Nursing Practice Instructions

 Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse\'s role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. 

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.