Evolving practice of Nursing and Health Care Models
Health care schanging; it is not just focused on the curative care but the disease prevention ystem is and wellness. Also, the new healthcare reform has approach to the development of healthcare delivery models with the changes in nursing role from acute care settings to community health care. Patient Protection and Affordable Care Act (PPACA) formed at 2010 support the establishment of ACOs, medical homes and nurse-managed health clinics; also new payment policies. With the formation of Affordable Care Act (ACA), health has transformed from traditional treating approach to the preventive and wellness. Nurse’s role has also changed from front-line caregiver to the care integrators and coordinators and help in providing the health services to the underserved people. All the health models are focused on the concept of continuity of care which is defined as “a concept involving an integrated system of care that guides and tracks patient over time through a comprehensive array of health services spanning all levels of intensity of care” (Evashwick, 1989). It covers the delivery of healthcare over a period of time and for all levels and stages of care. Let’s talk about the three types of health care delivery model.
Accountable Care Organizations (ACOs)
In accordance to the Center for Medicare and Medicaid services, “Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (Cms.gov, n.d.). The ACO is the new unit built by the ACA; the health reform law 2010 which take care of the cost and quality of the care received by the patients. The main aim of ACO is to deliver flawless and high-quality care at the right time to the patients, especially the chronically ill patients. The ACO include the specific group of providers and suppliers assigned by the ACA and they encourage the active participation of nurse practitioners (NPs), clinical nurse specialists (CNSs) etc with physicians and physician assistants. As nursing leadership is encouraged in ACO, registered nurses can lead in quality assurance and develop the improvement initiatives (Nursingworld.org, n.d.).
Medical Home/Health Home
Medical homes (patient-centered medical homes, PCMH), similar to Accountable Care Organizations are primary health care delivery model focused on the deliverance of the primary care that is patient-centered, managed, synchronized, accessible, ample and believe in quality and safety. “The medical home is not a final destination instead, it is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient’s needs” (Pcpcc.org, n.d.). This medical health model helps in solving the health care costs problem with the support of primary care providers such as physicians, nurse practitioners and certified nurse-midwives. Nurses being front-line healthcare workers play a vital role in this model as they can actively participate in health promotion and disease prevention, order and interpret laboratory tests and other studies and refer the patients who need specialized care.