Health Care Delivery Models, Nursing Practice, and Emerging Trends

This report examines the evolving healthcare delivery system in the United States, emphasizing reforms, laws, and their impact on nursing practice. It discusses the Affordable Care Act, pay-for-performance models, and their effects on patient outcomes and nursing roles. The paper highlights the importance of professional nursing leadership and management in responding to emerging trends and promoting patient safety. Furthermore, it explores the anticipated growth and transformation of nursing practice within the next five years, considering technological advancements and changing demographics. The report underscores the critical role of nurses in facilitating quality healthcare and adapting to the dynamic healthcare environment, referencing relevant research and literature to support its analysis.

Running head: HEALTH CARE DELIVERY MODELS AND NURSING PRACTICE 1
Health Care Delivery models and nursing practice
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HEALTH CARE DELIVERY MODELS AND NURSING PRACTICE 2
Introduction
The health care delivery system in the United States has undergone rapid changes that
emphasis more on population health, quality of service, effectiveness, and efficiency of the
services delivered. These reforms have helped a lot in tackling health challenges faced in the
United States. The United States has invested more in health services than other advanced
countries, and that why its health system is so far the best as per international standards. Nurses
have played a vital role in these reforms and elevated from caregivers to care integrators. This
paper will review changes introduced to reform the United States health care delivery system,
healthcare laws, and nursing roles and responsibility in health care delivery.
Emerging HealthCare law
One thing that facilitated these reforms in the United States was a law passed in
Massachusetts in 2006, which enabled near-universal health insurance coverage. This success in
Massachusetts law showed that it was possible to achieve universal coverage with state support.
Massachusetts reform policy was about the insurance purchase plan, and it was mandatory to
purchase failure to which one would be fined (Glied & Altman, 2017).
Affordable Care Act
The Affordable Care Act (ACA), commonly known as Obamacare, was sought to
address lack of insurance coverage, enable less expensive coverage, and increase access to health
care. There was a high penalty to all those uninsured. ACA improved quality and reduced costs
by allowing low pay in hospitals for many health services. Also, it permitted insurance of your
children by your plan until they are 26 years.
There are several ways the Affordable Care Act will affect nursing practices. They
include the increase in the demand of registered nurses in the United States compared to other

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professions. This boosts financial standing since there will be an increase in payment of
Medicare services to all nurses as certified midwife pay will rise by 36%. The total nursing
population will increase because a significant population would like to advance training in
nursing (Carter, 2019).
They have provided implementation to allow nursing students to get high loan amounts
from the government. These loans had not been reviewed for a long time. Despite the increase in
higher education costs, many students could not afford to live a comfortable life in training.
Nursing students will now be able to access these loans to meet current training costs (Fiscella &
Sanders, 2016). Besides, the law set aside money for pilot clinical initiatives test that will require
the services of trained nurses. These changes will involve sending qualified nurses to poor
mothers to educate them on good health during pregnancy and also in early childhood growth.
These will provide nurses with an opportunity to take part in redesigning the health care delivery
model (Glied & Altman, 2017). According to Blumenthal & Nuzum (2015), the law has raised
awareness about the roles of nurses in health care provision. Therefore, this gives nurses a
platform to showcase what they do and their impact on quality care. Also, the effect on the role
of the nurses is their advanced training and an increase in payments.
How Pay-for-Performance Affect Patient Outcome
Pay for performance is a program that gives financial rewards to health care workers to
motivate them to work harder for good patient outcomes. The Affordable Care Act expands the
use of pay for performance in the hospital to drive health workers to achieve better outcomes for
the patients. The increased payments are significant in motivating health workers and result in
positive attitudes toward work, enhancing maximum human productivity. Since pay-for-
performance emphasis more on patient outcomes, attention to how the nurse is affected by must

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follow. Nursing leadership must address the way to determine the impact of pay for performance
to nurses and how they can achieve pay for performance standards by educating nurses (Jacobs,
2019).
Pay for performance has made nurses overwork, leading to work-related stress and can
have higher risks if implemented carelessly. Therefore, if nurses do their responsibilities
hurriedly, it can result in mistakes and casualties at their workstation (Glied & Altman, 2017).
According to Kingma (2018), financial incentives programs make payment conditional in
providing health care services.
Professional Nursing Leadership and Management Roles
Strong leadership is critical in achieving quality and transformed healthcare system.
Additionally, nurses will need strong leadership skills to be able to contribute to reforming the
healthcare system. Professional nursing leadership should ensure that the correct nursing policies
are implemented by embracing proper ideas. It will assist in bringing solutions to the nursing
management that will make the profession sustainable (Omer, Suliman, & Moola, 2016).
Nursing leadership should be in a position to defend nurses' welfares and fight for the right
working conditions for nurses. They should also make good policies to attain quality patient care.
Nursing leadership should advise the government to reform nursing schools to have modern
hospital machines. According to changing technology, they should prepare nurses to shift to
these new trends in nursing.
Emerging Issues
Nursing professional has experienced significant transformation and is still transforming.
Some of the emerging issues expected in the future. Hence, there will be continued growth in
technology, and advanced robots that can-do nurse work will emerge. This robot will assist

HEALTH CARE DELIVERY MODELS AND NURSING PRACTICE 5
nurses in carrying quality health care services. The practice of nursing and their roles in the next
five years will change through accuracy brought by technology and early detection of illnesses
leading to early diagnosis. The increasing retirement age will cater to increased nursing demand
after the introduction of the affordable care act and an increase in health insurance (Jacobs,
2019).
Conclusion
The United States health care system has undergone a transformative change. Nurses are
the largest group of health workers, and they are involved in different platforms of the health
sector and are very critical in these transformations in the health care system. Nurses have played
a vital role in these transformations and facilitation of quality health care. Pay for performance
should be carefully implemented. Despite its positive impacts, it can also negatively affect a
nurse's quality of service. Nursing schools should incorporate new reforms in terms of
technology to ensure nurses are successful in providing patient care. Trainers should design new
programs to ensure nursing students gain more knowledge of new trends in health care.

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References
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years. Nursing
Ethics, 6(7), 38-53
Carter, L. E. (2019). Health Care Reform: policy innovations at the state level in the United
States. Routledge.
Fiscella, K., & Sanders, M. R. (2016). Racial and ethnic disparities in the quality of health
care. Annual review of public health, 37, 375-394.
Glied, S. A., & Altman, S. H. (2017). Beyond antitrust: health care and health insurance market
trends and the future of competition. Health Affairs, 36(9), 1572-1577.
Jacobs, G. (2019). Patient autonomy in-home care: Nurses' relational practices of responsibility.
Nursing Ethics, 26(6), 1638-1653.
Kingma, M. (2018). Nurses on the move: Migration and the global health care economy. Cornell
University Press.
Omer, T. A., Suliman, W. A., & Moola, S. (2016). Roles and responsibilities of nurse preceptors:
Perception of preceptors and preceptees. Nurse education in practice, 16(1), 54-59.
World Health Organization. (2018). Antimicrobial resistance and primary health care: a
brief (No. WHO/HIS/SDS/2018.57). World Health Organization.

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