Introduction
One of the current healthcare laws that were introduced to reform various aspects of the health care delivery system is the Patient Protection and Affordable Care Act (PPACA). The law was signed by former President Obama in 2010. The law was expected to have a general impact on healthcare providers, consumers, insurers, payment policies, Medicare and Medicaid (Maga & Lewis, 2014). In the current nursing practice, policymakers have acknowledged that there is a need for increasing the nursing workforce to provide quality care for millions of patients that will be included in the PPACA. The policy is based on the fact that there is a considerable shortage of nursing staff within the nursing profession. As a result, multiple provisions have been developed to address the issue of nursing staff shortage in the United States.
One of the provisions that were expected to impact on the nursing profession is section 5202 nursing student loan program. This provision of the law was expected to update the amount of loans for nursing students. This program has and will help to increase the number of students admitted to nursing schools. In section 5208 of nurse-managed health clinics, the provision had planned to authorize a $50 million grant to be used in running nurse-managed health clinics. The aim has been to promote the provision of comprehensive primary services among low-income groups or those without medical covers.
Affordable Health Care
Despite the implementation of the Affordable Health Care Act, healthcare spending remains out of control. Research reveals that without the proper checks and balances, Healthcare spending is expected to increase from 18 percent to 25 percent of the GDP by 2040 (Buchmueller, Levy, & Valletta, 2018). It is two years since its implementation, and some areas have improved, but many US citizens have yet to realize the benefits of the reform. Notably, there is a need to revise the current payment systems to reflect on the current economic constraints. The healthcare industry should also completely dismantle the current system and start over. In the first case, the industry should adjust the payment rates to match global targets. There should be setting up independent economists, consumers, businesses, payers, and providers who would be required to enforce the spending targets to contain high costs. The federal government should also promote self-regulation models through the provision of grants to the states (Flexibles & Crocker, 2018). This strategy should be a systematic process whereby each sector should be addressed one at a time. In the new system, health care providers should be required to publicly report the measure of cost, access, and quality in the sector. Bonus payments should be provided for effective providers to motivate them to achieve high performance.
Bundle Payments
Another reform should be the use of alternative methods instead of the previous ancient methods of Fee-for-Service Payments (Press, Rajkumar, & Conway, 2016). Patients should make bundled payments for services rather than paying fixed amount to hospitals and physicians. This strategy should be inclusive of the post-care and rehabilitation for about three months after discharge.
The healthcare industry should use competitive bidding for all commodities, as many tend to have excessive pricing (Whitford, 2007). The system should allow suppliers and manufacturers to compete through the market forces to offer the supplies at lower prices instead of the previous system, where the government had the sole responsibility of setting the prices. In 2011, competitive bidding on medical equipment reduced Medicare spending by 42 percent. This strategy should also be extended to radiologic diagnostic services, laboratory tests, and medical devices (Frenk & Moon, 2013). It should be overseen by academic and business experts to ensure efficiency in price reduction as well as transparency.
Reducing Prices on Drugs
The other way is to simplify the administrative systems for all the providers and taxpayers. The United States has seen a 14 percent excess administrative spending of about $360 billion. Providers and payers are supposed to exchange claims and eligibility to minimize expenses electronically (Bates & Bitton, 2010). Second, providers and private payers should use a single standardized crediting system. Third, there should be provisions of paper and electronic statements that payers should provide to explain the benefits on a one-month basis. The fourth step entails integrating the administrative and the example of the clinical function payments, authorization, and billing. To monitor quality and control the process, the federal government should develop a task force to monitor user rates, set compliance targets, and other relevant measures to control spending.
The prices should be transparent. In this case, consumers who know the prices ahead of their visits to the healthcare centers have the power to choose low-cost providers (Azar, Mnuchin, & Acosta, 2018). This method can be hard, but as it could facilitate collusion and require antitrust laws that are aggressive to be enforced. The bundles should compose one price that integrates all the costs to be addressed by the insurer and information that pertains to the discounts by the sectors. It should have individualized estimates of out of customer's pockets costs and information about the number of patients and quality of care provided to the outpatients so that the stakeholder can make informed choices. Insures and surgeons have already agreed on flat-fee pricing on the healthcare sector. This strategy allows consumers to pay fixed charges for vitreous procedures, glaucoma, and cataract operations.
Professional nursing leadership and management should ensure that nurses and physicians are full partners with physicians and other health care providers during the delivery of health care services (Huston, 2008). Strong leadership in nursing practice will promote the transformation of the health care systems. Besides, nurses will have a chance of practicing to the full extent of their training, hence meeting the goals of the Institute of Medicine (IOM) report. There will be an enhanced provision of patient-centered and community care services. Collaboration among nurses and other healthcare professionals will encourage the utilization of innovative and cost-effective approaches during patient care. The net result will be to reduce medical errors, increase patient safety, and eradicate the chances of redundancy.
The reforms will simplify billing for outpatient treatments by reducing administration charges and costs (Haggerson, Engman, & Estes, 1999). The sector will also have more competitive elements; the efficiency of healthcare will increase. It will also be advantageous to the patients as they will have more freedom to choose from many providers, thereby shifting from basic coverage to more healthcare coverage.
The healthcare provider will be rewarded for their best performance. It will also prevent a few individuals from exploiting patients because the systems will be driving the costs, and it is not easy to exploit the complicated system (Pugsley, Brigley, Allery, & Macdonald, 2008). The medical quality standards will be good because of the full automation of services with every doctor or physician having internet access. Besides, the federal government will save on the new healthcare model. It is estimated that over half a billion will be saved in the first year of its implementation. It will also have better control of the entire healthcare industry sector by increasing efficiency in the provision of reliable healthcare for American citizens.
Conclusion
Implementation of the above reforms will ensure quality and cost friendly health care for the citizens. The government should prioritize the changes and allocate funds for the implementation process. Lastly, the federal government should be ready to solve some of the challenges it may face.
