NURS 8100 Staying Current Online Resources

NURS 8100 Staying Current Online Resources

Technology is providing increasingly rich and credible resources for staying abreast of the latest trends and issues in health care. Many recognized organizations provide regularly disseminated updates via their websites, and offer this information free to subscribers. As you proceed through the DNP program, you will find that receiving these updates will support your professional growth as a scholar practitioner.

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Explore the following resources found in this week’s Learning Resources:

AHRQ Patient Safety Network
Modern Healthcare Alerts
RWJ Nursing News Digest
The Commonwealth Fund
The Henry J. Kaiser Family Foundation

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Week 1 Assignment

RE: Discussion Week 1
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Having equal access to care opportunities for all citizens to lead healthy lives, translates to achieving health equity, the “attainment of the highest level of health for all people” (Gómez et al., 2021). The toxic combination of poor social policies, unfair economics, and bad politics created health inequities, requiring health policies to be enacted, to alleviate societal health disparities, and favorably influence health outcomes for most Americans.

The health policy passed by President Obama was to address longstanding structural drivers of health inequities, caused by precarious and adverse working conditions, growing economic disparities, anti-democratic political processes, institutions, breaches, racial and social inequities, disparities in health delivery, especially in the minority communities (Paremoer et al., 2021).

There are multiple notable features of the U.S. health care system, and telehealth medicine is interesting to me. It has been described as a gamechanger in care delivery, however, remained underutilized in healthcare, due to limited reimbursement, to rural providers and those in two-sided risk models. These virtual visits are usually short to the point, eliminate driving time, and are fully accessible to all populations, especially the vulnerable ones, more so in rural areas, minorities, seniors with comorbidities, with top spending tiers for health care expenditures.

The Covid-19 pandemic fundamentally shifted the ground, and crystallized the need for new reimbursement policies, for a broader array of ambulatory services, regardless of geography, leading to dramatic uptake. The Premier data indicates that due to COVID-19, the virtual visits in the ambulatory setting increased by a factor of 30 year over a year (Smith & Raskin, 2021), reaching at-risk populations in 2021. It is becoming an integral strategy for population health management, by improving access, adherence, and overall wellbeing.

The act makes health-care coverage more equitable by providing subsidies, premium tax credits, and cost-sharing reductions. However, payers must cover preventive services, immunizations, annual examinations, and screenings. It allowed young adults to remain on their parents’ health insurance plans until they turned twenty-six. This means that payers must cover these medical costs in the patients’ policies, which is a concern because it raises costs for payers, who can then pass the costs on to consumers. This results in very high deductibles, “narrow provider networks, and enriched drug firms, medical conglomerates, and insurers” for the covered families (Himmelstein & Woolhandler, 2017).

There are also mandates requiring eligible citizens to have healthcare coverage or face penalties, so self-employed individuals have no choice but to purchase expensive plans through the health insurance marketplaces. The ACA also imposes price ceilings on Medicare payments to providers, which eventually leads to fewer health care options and lower quality of care for the Medicare population (Hammer et al., 2010). The Trump Administration had a goal of repealing the ACA, which was supported by a number of Republican-led states that filed law-suits for the law’s ineligibility based on their opinions (Vogenberg, 2019).

They were united in their desire to undo what Obama had done; however, drafting the replacement act became extremely complicated, and going halfway, or repealing without a better replacement, would cost thousands of lives (Himmelstein & Woolhandler, 2017). They required health reform legislation that included provisions for foundational health services as well as sufficient access to benefit the nation, given the value of tax dollars spent on healthcare (Stephens & Ledlow, 2010). Changes to health plans, Medicare payments, Medicaid expansion coverage, readmission penalties, and increased payments to primary care physicians and community health centers will all have an impact on providers (Hammer et al., 2010).

All of these issues must be addressed through legislation, and ongoing squabbles among legislators put millions of Americans at risk of losing their health insurance (HeatlhCare.gov). Healthcare reforms will also necessitate bipartisan agreement in Congress, with specific, articulated health policy goals from each party, an extremely difficult task given that both the Republicans and Democrats disagree and have different priorities. Republicans prioritize lowering costs and smaller government over all other goals, whereas Democrats prioritize improving health and equity, resulting in fundamental conflict, the government’s role in health care provision, and subsidizing tradeoffs between lowering costs and increasing access (Pagel et al., 2017).

References:

Devore, S. (2021). Health Care In 2020: Five Trends to watch. Health Affairs.

Gómez, C. A., Kleinman, D. V., Pronk, N., Wrenn Gordon, G. L., Ochiai, E., Blakey, C., Johnson, A., & Brewer, K. H. (2021). Addressing Health Equity and Social Determinants of Health Through Healthy People 2030. Journal of Public Health Management & Practice, 27, S249–S257. https://doi.org/10.1097/PHH.0000000000001297

Hammer, D., Phillips, B., & Schmidt, T. L. (2010). The intended and unintended consequences of healthcare reform. Healthcare Financial Management: Journal of the Healthcare Financial Management Association, 64(10), 50–55.

HealthcareCare.gov. (n.d.). Understanding the Affordable Care Act. https://www.hhs.gov/healthcare/about-the-aca/index.html

Himmelstein, D. U., & Woolhandler, S. (2017). Trumpcare or Transformation. American journal of public health, 107(5), 660–661. https://doi.org/10.2105/AJPH.2017.303729

Pagel, C., Bates, D. W., Goldmann, D., & Koller, C. F. (2017). A Way Forward for Bipartisan Health Reform? Democrat and Republican State Legislator Priorities for the Goals of Health Policy. American journal of public health, 107(10), 1601–1603. https://doi.org/10.2105/AJPH.2017.304023

Stephens, J. H., & Ledlow, G. R. (2010). Real healthcare reform: focus on primary care access. Hospital Topics, 88(4), 98–106. q

Smith, S. & Raskin, S. (2021). Achieving Health Equity! Examining Telehealth in Response to a Pandemic. The Journal for Nurse Practitioners, 17 (2): 214-217

Paremoer L, Nandi S, Serag H, Baum F. (2021). Covid-19 pandemic and the social determinants of health BMJ; 372: n129 doi:10.1136/bmj. n129

Vogenberg, F. (2019). US healthcare tends and contradictions in 2019. American Health & Drug Benefits, 21 (1): 40-4

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