Affordable Care Act and Patient Advocacy

The Patient Advocacy facilitates informing the patients, communicating with them, speaking out for their preferences, protecting them and developing nurse-patient relationships. The ACA enables the nurses to play various roles in changing paradigm of care.

Running Head: Affordable Care Act and Patient Advocacy
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Affordable Care Act and Patient Advocacy
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Affordable Care Act and Patient Advocacy 2
Introduction
The relationship between the patients and the healthcare providers is largely based on patient
advocacy. Many times patients encounter several healthcare challenges in interpreting their
diagnosis, recognizing the meaning of difficult medical terms, and understanding the
requirement of preventive and follow up care. The patient advocacy involves extending nursing
support for the patients by explaining them difficult medical terms, their prescription and
medications, clarifying healthcare goals to them, and instructing them about different alternative
treatments and procedures. It helps the nursing professionals in establishing trust within their
relationships with the patients, encouraging their contribution in clinical decisions, and
identifying the needs of individual patients in this regard.
Patient Advocacy can be defined as ‘the practice of informing patients, communicating with
them, speaking out for their preferences, protecting them and developing relationships with
them’ (Ronnebaum & Schmer, 2015).
Contributing to safe practice
Safe healthcare environment can be developed to promote sanitation, hygiene, ventilation and
comfort. While dealing with culturally diverse patients, the healthcare providers must take care
of the issues like inadequate health literacy, socioeconomic disparities and medical mistrust
which may be there in the minds of these populations. Such issues may hinder the delivery of
favorable care thereby increasing the rate of health disparities and chronic illness in these
patients. The nurses are required to deliver culturally acceptable care to lower down the rate of
chronic diagnosis, enhance the communication and trust in relationship.

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It is necessary to include patient advocacy in nursing curriculum. The nurses learning patient
advocacy in their curriculums can apply it in an effective manner in the care settings. The
nursing students should be given quality training to address the needs of terminally ill patients to
enhance their awareness, power and confidence.
Patient Advocacy may also facilitate controversial and negative consequences in form of
disagreements between the nurse and patients, or nurse and physicians. In such cases the nurses
must equally respect the rights of patient autonomy while advocating for their preferences.
Role of Nurse and how nurses will advocate for healthcare consumers/ Patients
According to American Nurses Association’s code of practice for nurses, their role may extend
to responsibilities like explaining healthcare policies to the patients, protecting their rights, and
respecting their decisions in the treatment (Ronnebaum & Schmer, 2015). The nurses can
provide the patients with all the necessary information they need to make decisions and give
their informed consent. They need to care for the patients, value them and assist them.
According to Baldwin, the nurses may act as intermediates between the healthcare providers and
the patient and his family (Ronnebaum & Schmer, 2015). He elaborated the three attributes of
nurse’s role as following: (a) Valuing- The nurses can empower the patients, their self
determination and freedom (b) Interceding- The nurses can help the patients in getting through
the barriers of healthcare requirements (c) Apprising- The nurses can educate, inform and advice
the patients (Ronnebaum & Schmer, 2015).

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According to research by Bu and Jezewski, the three attributes of patient advocacy can be (a)
Acting on behalf of the patients (b) Protecting the autonomy and rights of patients (c) Promoting
the social justice in best interest of patients (Ronnebaum & Schmer, 2015).
The nurses must be aware of the advocacy requirements of their patients, the best healthcare
interests of patients and the actions needed to be taken in different conditions. These attributes
provide control of patient’s treatment in the hands of patients and ensures that the needs of
patients are met.
The nurses can educate the patients and their families, can communicate with other clinicians,
assuring best care to the patient, while evaluating the decisions taken by the patient.
Relevant Policy (PPACA) and stakeholders
According to Schwartz, multiple stakeholders like patients, physicians, family, professional
advocates, friends can also advocate for the patients (Ronnebaum & Schmer, 2015). In 2010, the
US President announced Patient Protection and Affordable Care Act (PPACA) which allowed
the safe, affordable and quality health care support for all the US citizens (Ronnebaum &
Schmer, 2015). It provided affordable rates of health insurance, coverage to immediate medical
assistance and preventive care, and no annual or lifetime limits for premium. Earlier due to
higher costs of health insurance and other concerns of socioeconomic importance, many
populations did not have health insurance. The PPACA made it feasible for this diverse range of
populations from economically backward uninsured classes like African Americans, Latinos,
Pacific islanders and Asian Americans to avail the benefits of health insurance.

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What organization would you develop to advocate for the public and why?
American Cancer Society, is a national voluntary health advocacy organization working to
eradicate cancer. It provides several non-profit funding programs for cancer research, diagnosis,
detection and treatment. The Organization has been attributed to its role in eradicating more than
half million deaths due to cancer in United States (American Society of Clinical Oncology,
2019). It enabled the development of cancer treatments with very few side effects. Its researches
have confirmed the role of cigarette smoking and obesity in spreading different types of cancers.
I would like to develop this Organization due to its highly effective role in prevention and
treatment of cancer. The cancer patients require support, and public awareness to manage the
disease. Cancer patients need patient advocacy to improve their quality of care, access to
affordable insurance to meet the expenses of treatment, addressing the job discrimination and
disparities in care.
Future role of Nurse changing as a result of policy changes
The ACA has brought many more people in the range of being insured. It observed an increase in
the number of new patients. Many of these new patients suffered from chronic illness and hence
they needed critical care and their health requirements may be highly complex. Such patients
imposed additional burden on the nurses, enhanced emergency room visits, further increasing the
waiting times and work load of patients on the clinicians.
The ACA shifted healthcare delivery from hospitals to communities which further increased the
level of outpatient work for the nurses (U.S. Bureau of Labor Statistics, 2018). The nurses have

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to work for longer durations and harder with fewer resources. The policy changes imposed
additional set of responsibilities on the nurses. The nurses with expertise in care management,
home care, community health care and case management are increasingly in greater demands
(Salmond & Echevarria, 2017).
Role of your chosen profession (Nursing) changing in the near future
ACA facilitated new principles for the payment of medical expense in form of Value based
Purchasing (VBP), Pay for Performance (P4P), Shared Savings Arrangements, Bundled Payment
models, Patient Centered Medical Homes and Hospital Readmission Reduction Programs
(Salmond & Echevarria, 2017). These healthcare reforms are directed to transform the care
delivery from disease oriented model to the quality and health outcomes focused model. As the
paradigm will shift towards patient centered healthcare, the payment will be done not only for
treatment but also for prevention, care management and care coordination. The future will
observe several changes like timely access to healthcare, collaborative team based care, shared
risk for using the specialized services, quality measured for longer periods at aggregate and
individual levels.
The comprehensive care will demand multidisciplinary roles for nurses like in clinical care,
nurse education, health behavior management, administration, data analytics, Community
Resources, facilitators and preventive care (Health and Human Services, 2014). Nurses need to
identify the changes in the nursing practice, delivering a holistic program of care in best interest
of the patients.

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Practicing in patient and family centered care, the nurses must be aware of patient’s cultural
preferences and must respect their role in taking healthcare decisions. The nurses are also
required to be culturally aware and informed about different cultures so that they can handle
culturally diverse set of populations effectively (Ronnebaum & Schmer, 2015). The nurses must
be equipped and trained enough to deliver safety, effectiveness, patient centeredness, respectful
timely, equitable and efficient healthcare. Instead of focusing on the task, they need to focus of
the patient experience, wellness, health education programs and excellence. The nurses,
physicians, therapists and other social workers may partner up with the community centers (like
housing and adult day care) and may take part in shared medical appointments to enable skill
development, education and support to extend healthcare ventures. The nurses need to ensure
that the decisions taken respect the preferences, and needs of the patients and their families. The
nurses need to provide the patients and families adequate education to take part in their own care.
Conclusion
The Patient Advocacy facilitates informing the patients, communicating with them, speaking out
for their preferences, protecting them and developing nurse-patient relationships. The ACA
enables the nurses to play various roles in changing paradigm of care.
In future the new roles of nurses will require new cognitive approach to enhance value and
increase the health outcomes. Health services need to be promoted across the continuity of care.
The nurses need to take a central role in delivery of patient care to make the care more quality
driven and patient centered. The healthcare will demand multidisciplinary roles for nurses like in

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clinical care, nurse education, health behavior management, administration, data analytics,
Community Resources, facilitators and preventive care.
References
American Society of Clinical Oncology (2019). Being a Cancer Advocate. Retrieved from
https://www.cancer.net/research-and-advocacy/patient-advocates/being-cancer-
advocate
Health and Human Services[HHS] (2014). HealthCare. Retrieved
from http://www.hhs.gov/healthcare/facts/factsheets/index.html
Ronnebaum, E.D., & Schmer,C.(2015). Patient Advocacy and the Affordable Care Act: The
growing need for nurses to be culturally aware. Open Journal of Nursing
5(3), Article ID:55144, 1-8. DOI: 10.4236/ojn.2015.53028
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for
Nursing. Orthopedic nursing, 36(1), 12-25.
U.S. Bureau of Labor Statistics (2018). How the Affordable Care Act Has Impacted
Nursing. Retrieved from
https://www.allnursingschools.com/articles/obamacare-and-nursing/