HEALTH CARE DELIVERY MODEL (Essay Sample)

Health Care Delivery Models and Nursing Practice Student’s Name Institution Affiliated Instructor Course Date Health Care Delivery Models and Nursing Practice Introduction In the last few years, there has been much change in the U.S. healthcare system. These changes have impacted not only the health landscape but also designed shifts that transformed the roles and responsibilities of health workers, especially those serving in capacities like nursing (Haldane et al., 2021). This paper will go into recent reforms, their impact on nursing practice, quality measures and pay-for-performance factors affecting healthcare, new emergent nursing leadership and management roles, as well as some prognostications about the future of nursing in the changing context of healthcare. Reform and Restructuring Initiatives The No Surprises Act was only passed in 2020 with the Consolidated Appropriations Act of 2021 after the surprise billing problem had become so endemic. The bill bans balance billing for out-of-network emergency care, ensuring that the patients receive the same rate as the in-network services (Hoadley & Lucia, 2022). It creates an external dispute resolution process for out-of-network non-emergency cases, leaving space for fair payment determinations. Transparency requirements demand that providers disclose the network's status and estimated costs in advance, therefore making informed decisions. The act is supposed to eliminate financial burdens by increasing predictability, increasing cost predictability, and enhancing relative provider-patient relationships (Hoadley & Lucia, 2022). Despite the more significant chattered bumps along the bumpy ride, the No Surprises Act heralds an astonishing new era in refashioning the health delivery system (Hoadley & Lucia, 2022). The No Surprises Act greatly affects the practice of nursing. In most instances, the nurses are the immediate direct care providers and activators who play a vital role in emergency case management. At some points, they also serve as patient service coordinators (Schechter & Sklar, 2022). It requires that the patients not be held accountable financially for any rentals out-of-network for these emergency services, which might have been unexpected and resulted in exorbitant bills. Nurses will be able to advocate for patients in emergencies, help facilitate communication between providers and become an integral component of the overall process of patient care (Schechter & Sklar, 2022). Nurses' responsibility under the No Surprises Act would involve effectively communicating with the patients about their rights, educating them on the legislation, and working with interdisciplinary teams to eliminate such surprise billing. In addition, nurses may be involved in designing and implementing internally flowing policies and procedures with the act, thereby enabling patients to receive clear information regarding financial matters of health (Schechter & Sklar, 2022). Quality Measures, Pay for Performance, and Nursing Practice Quality measures and pay-for-performance initiatives have taken center stage in healthcare, touching on patient outcomes and transforming nursing practice. These initiatives focus on linking reimbursement with quality of care and thus reward healthcare providers for offering quality, patient-driven services (Mathes et al., 2019). Quality measures should be inclusive and cover the Hospital's Value-Based Purchasing (VBP) Program, including patient safety, effectiveness, efficiency, and patient satisfaction. These measures enable the result of the patient to be improved indirectly - that is, motivating healthcare institutions to embrace evidence-based, efficient, and patient-centered care (Mathes et al., 2019). This implies that for nurses, there will be ample emphasis on following the clinical guidelines, effective communication, and engaging patients in enhancing the outcome. Pay-for-performance models relate financial rewards to achieving very specific quality metrics beforehand. This approach tends to motivate healthcare providers like nurses to offer an immediate impact that effectively guarantees and sustains high-performance standards (Bastani et al., 2019). It may involve implementing evidence-based interventions in nursing practice and participating in quality improvement projects with a higher commitment to patient safety (Bastani et al., 2019). Financial incentives associated with performance pay enable the nurses to always work towards developing high-quality care. However, the nursing role in quality measures and pay for performance is not restricted to patient care. They help collect and document the pertinent data and take the fore in interdisciplinary collaboration to ensure that care is effectively coordinated according to set standards (Bastani et al., 2019). The activity of patient education comes into the fore since an informed and involved patient is likely to follow through instructions, hence giving a better prognosis. Nurses are getting increasingly involved in leadership roles that relate to quality improvement. This includes working in committees and quality improvement teams and developing evidence-based protocols to improve care delivery (Mathes et al., 2019). Ultimately, the nurse's expectations and roles concerning quality measures and pay for performance depend on safe, patient-centered, and high-quality care because they engage in continuous improvement to enhance patient results (Mathes et al., 2019). Professional Nursing Leadership and Management Roles Professional nursing leadership and management roles have evolved to address the dynamic healthcare landscape, responding to emerging trends and promoting patient safety and quality care across diverse settings. Chief Nursing Officers (CNOs) and Nurse Executives are key leaders who play pivotal roles in shaping organizational strategies and policies (Ellis, 2021). Nursing leaders are essential in fostering a culture of innovation and adaptability in response to emerging trends such as technological advancements, population health management, and value-based care (Ellis, 2021). They guide integrating technology into nursing practice, ensuring that it enhances patient care, streamlines workflows, and contributes to improved outcomes. Additionally, nursing leaders collaborate with interdisciplinary teams to implement population health initiatives, addressing the broader determinants of health (Ellis, 2021). Nurse Managers, another critical leadership role, operate at the frontline, translating organizational goals into actionable plans. They are responsible for creating and sustaining a safe and supportive work environment, which directly influences patient safety and the quality of care (Yoder-Wise & Sportsman, 2022). Nurse Managers implement evidence-based practices, oversee staff education and training, and actively engage in quality improvement initiatives to enhance care delivery. Such leaders shall build a culture that encourages continuous learning, adaptability, flexibility and collaboration (Yoder-Wise & Sportsman, 2022).  Emerging Trends and the Future of Nursing The following are some emerging trends likely to shape nursing practice in the next five years significantly: Integration of Artificial Intelligence (AI) and Technology, Focus on Community-Based and Preventive Care. Artificial intelligence and technology, included in healthcare advancement, are poised to transform nursing practice (Wakefield et al., 2021). In the future of nursing, working with AI tools more often will be a duty for the nurse to perform data analysis, diagnostic procedures, and predictive modelling. This adoption has brought about efficiency in patient c...