NURS 8100 WEEK 1 Discussion Health Care Reform

Walden University NURS 8100 WEEK 1 Discussion Health Care Reform – Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8100 WEEK 1 Discussion Health Care Reform assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8100 WEEK 1 Discussion Health Care Reform

Whether one passes or fails an academic assignment such as the Walden University NURS 8100 WEEK 1 Discussion Health Care Reform depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8100 WEEK 1 Discussion Health Care Reform

The introduction for the Walden University NURS 8100 WEEK 1 Discussion Health Care Reform is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8100 WEEK 1 Discussion Health Care Reform

After the introduction, move into the main part of the NURS 8100 WEEK 1 Discussion Health Care Reform assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8100 WEEK 1 Discussion Health Care Reform

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8100 WEEK 1 Discussion Health Care Reform

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8100 WEEK 1 Discussion Health Care Reform

Feature of the Health Care System 

One feature of the US health care system is that it is the most expensive healthcare in the world with results that would not agree with the cost. It is interesting to see that the US healthcare system has tried to evolve over the years and in that evolving has actually increased the cost of healthcare (Bodenheimer & Grumbach, 2020). Competition has fueled the improvement of healthcare, but at the cost of raising healthcare costs for the individual. There are other countries that have better health care systems in place, for a fraction of the cost. It would be interesting to investigate the actual cost of care and how much insurance companies gain compared to their actual payout. There is much that could be improved in the US health care system. It could be possible that the monetary issues prevent there from being major reform to the system because companies make such a large sum of money that they do not want things to change. As the US health care system has tried to change and become seemingly more affordable through the use of policy changes there has been an increase in the amount of money that they government pays, which is actually paid by US citizens through taxes (Bodenheimer & Grumbach, 2020). It seems that whenever the US health care system is taking one step forward it is also taking two steps back. 

Challenges 

The Affordable Care Act (ACA) did provide more individuals with health care coverage. This has improved the health of many individuals. One condition of the ACA is that it protects individuals with preexisting conditions from insurance companies denying care based on their condition (Healthcare.gov, n.d.). This is a great benefit for many individuals, but it comes at a cost for the insurance companies. This mandatory coverage causes insurance companies to then have to try to balance out coverage for those individuals that are ill versus those individuals who are healthy which can end up costing those individuals that are healthy to pay for others in their groups (Bodenheimer & Grumbach, 2020). This causes insurances to have to base their premiums on an experience rating versus a community rating which potentially provides unfair coverage to individuals (Bodenhemier & Grumbach, 2020). This seemingly minor change from the ACA has a ripple effect in the way that insurance companies need to charge for care and how they will determine premiums for individuals. The ACA in general is an example of how the policy making process is in the United States. Making or changing policy in the United States is a very slow, very incremental process which makes it hard to change or add policies (Walden University, LLC, 2011). The ACA was a worked on for a long time and because of the changes that were made many companies had to adjust accordingly. Health reform in the United States is difficult because there are so many entities that want to make sure that they are not being left out or hurt in decisions or policies that are being made and so they will stall or stonewall different policies if they feel that it does not benefit them. When there are policy changes then there are adjustments that need to be made and sometimes that effects so many different things that the changes end up being a negative instead of a positive, such as individuals who have to pay too much for the ACA healthcare and therefore opt out and are fined for that decision (Bodenheim & Grumbach, 2020). 

References 

Bodenheimer, T., & Grumbach, K. (2020).  Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.  

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

Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: The policy process. Baltimore: Author. 

Sample Answer 2 for NURS 8100 WEEK 1 Discussion Health Care Reform

It is true that the US healthcare systems have been evolving. The evolution aims at making healthcare services more suitable due to the emerging healthcare conditions. Unfortunately, the evolution has made the cost of healthcare shoot (Wosik et al., 2020). Surprisingly, most uninsured Americans are now struggling to afford hiked medication bills. The advanced healthcare services that focused on making healthcare quality and patient satisfaction have turned into a nightmare for most Americans who cannot afford it. The introduction of the ACA and Medicaid programs are intervention mechanisms from the federal and the national governments.  Most American politicians understand the ramifications of the changes in the US healthcare system and the entire sector (Tran et al., 2019). Therefore, to avoid the increased inability of Americans to access quality healthcare services have forced the authority to intervene through insurance programs. Also, the policy change in the healthcare sector is targeting the most vulnerable Americans. People living with disability and the elderly population is among the targeted population.  Similarly, the government programs consider both the underemployed and unemployed Americans.   

References 

Tran, B. X., Vu, G. T., Ha, G. H., Vuong, Q. H., Ho, M. T., Vuong, T. T., … & Ho, R. (2019). Global evolution of research in artificial intelligence in health and medicine: a bibliometric study. Journal of clinical medicine, 8(3), 360. https://doi.org/10.3390/jcm8030360 

Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., … & Tcheng, J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27(6), 957-962. https://doi.org/10.1093/jamia/ocaa067 

Sample Answer 3 for NURS 8100 WEEK 1 Discussion Health Care Reform

The Affordable Care Act (ACA) was signed into law over 10 years ago and it has remained highly controversial by many law makers since its inception on March 23, 2010. Many law makers have tried to get rid of the ACA but have yet to find a health care system to replace the ACA that works with law makers and the public. Even though people may not like the ACA it has improved the health care system, provided health insurance to the uninsured, provided more prevention program to help improve the overall health of the American people. There was so much resistance to passing the ACA since the President at that time was African American and a Democratic (Silberman, 2020). The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congresspeople, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it during every election, but more than 50% of Americans support ACA. In the first year of ACA 10 million Americans gained accessed to health insurance. The ACA also eliminated the no coverage for prior conditions, it also decreased prescription drug cost and eliminated co-pay for preventive services. When people are asked why they oppose the ACA they mention they do not like the government involved in their healthcare, but they pay into Medicare which is a mandatory federal government insurance. Despite positive changes the ACA has brought to many Americans many politicians and people oppose ACA and want to get rid of ACA(Silberman,2020). While ACA has made great strides in improving health care, health disparity remains a major problem among people of color. The recent pandemic has shown the world once again that the health care system is even though Black Americans make up 13 percent of the US population over 23 percent of COVID deaths were Black Americans (USA, 2021).  

  In spite of significant advances in the diagnosis and treatment of most chronic diseases, there is evidence that racial and ethnic minorities tend to receive lower quality of care than non-minorities and that, patients of minority ethnicity experience greater morbidity and mortality from various chronic diseases than non-minorities. The Institute of Medicine (IOM) report from 2006 showed unequal treatment “racial and ethnic disparities in healthcare exist and, because that lead to worse outcomes in many cases. Minorities were provided less access to health care intervention, sources, and funding (Egede, 2006).  

References 

Egede, L. (2006). Race, Ethnicity, Culture, and Disparities in Health care  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924616

 Silberman, P. (2020). The Affordable Care Act: Against the Odds, It’s Working. North Carolina Medical Journal, 81(6), 364–369. https://doi-org.ezp.waldenulibrary.org/10.18043/ncm.81.6.364   

USA FACTS. (2021).US COVID-19 cases and deaths by state  https://usafacts.org/visualizations/coronavirus-covid-19-spread-map

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Sample Answer 4 for NURS 8100 WEEK 1 Discussion Health Care Reform

I agree with you that since the inception of the Affordable Care Act (ACA) under Obama’s regime the act has attracted intense controversies.  Most Republicans have shown their dissatisfaction with the policy. Also, some healthcare organizations have expressed mixed reactions (Eguia et al., 2018).  However, the attempts to get rid of the ACA have experienced challenges. Lack of a suitable replacement is a primary problem that has jeopardized efforts from some lawmakers to abolish ACA. The bill was made law over ten years ago after Democrats realized the plight of many uninsured Americans. African-Americans were the primary beneficiary of the initiative due to their low economic status in most households (Zhao et al., 2020). The ACA was introduced in the US healthcare sector that had other programs such as Medicaid that targeted Americans. Therefore, as the healthcare system continues to advance and become more expensive the government intervenes to ensure Americans can access quality and affordable healthcare services.    

References 

Eguia, E., Cobb, A. N., Kothari, A. N., Molefe, A., Afshar, M., Aranha, G. V., & Kuo, P. C. (2018). Impact of the Affordable Care Act (ACA) Medicaid expansion on cancer admissions and surgeries. Annals of surgery, 268(4), 584. doi: 10.1097/SLA.0000000000002952 

Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: a review at 10 years. CA: a cancer journal for clinicians, 70(3), 165-181. https://doi.org/10.3322/caac.21604 

Sample Answer 5 for NURS 8100 WEEK 1 Discussion Health Care Reform

Your work on health care reform is insightful and interesting. Indeed, politics is playing an important role in the US health care reforms and PPACA has remained controversial issue due to political differences.  The other challenge related to the passing of the PPACA is healthcare inequalities, which has disproportionately impacted the minority groups such as African Americans and marginalized groups (Yue et al., 2018).  While the PPACA coverage increased the progress towards universal coverage, the persistent high cost of various coverage options implies limited access to affordable health care among many Americans, especially the minority and marginalized groups (Gaffney & McCormick, 2017). These disparities lead to the gaps in health insurance coverage, poor health outcomes among minority and marginalized groups, and unequal access to services (Dickman et al., 2017). The issue of healthcare inequalities and other challenges portray why health care reforms in the US have been difficult.  They characterize systematic health care challenges that indicate that the US health care reforms are not comprehensive and fail to capture the health care needs of all Americans.

References

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441. https://doi.org/10.1016/S0140-6736(17)30398-7

Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: implications for health-care equity. The Lancet, 389(10077), 1442-1452. https://doi.org/10.1016/S0140-6736(17)30786-9

Yue, D., Rasmussen, P. W., & Ponce, N. A. (2018). Racial/ethnic differential effects of Medicaid expansion on health care access. Health services research, 53(5), 3640-3656. https://doi.org/10.1111/1475-6773.12834

Sample Answer 6 for NURS 8100 WEEK 1 Discussion Health Care Reform

This paper looks into an accountable care organization (ACO) in California and ways that it impacts population health. Accountable health care organizations play vital roles in promoting coordinated efforts between clinicians and medical practitioners while at the same time reducing costs and unnecessary treatments (McWilliams, 2016). Accountable care organizations are a representation of changing health dynamics in the American care system. Accountable care organizations are formed when medical providers, for instance, doctors, nurses, health organizations and non-physician providers collectively agree to be responsible for financial and quality of care in a defined population.

Accountable Care Organization

In California, one of the common ACOs is the Shared Savings Programs (SSP) which is a voluntary program that is formed to encourage hospitals, doctors and other health providers in the country to come together as accountable care organizations. The organization gives coordinated and high-quality care to members who are beneficiaries of Medicare. The SSP was formed wit the intention of moving the payment system of Medicare from a volume perspective to outcome and value-based (Lipa, 2020).  SSP has significantly impacted population health in California. By coming together, SSP has improved the quality of care to patients who could not have afforded such care. The SSP ensures that patients from different areas in the state get the correct care at the right time. Quality care also means that patients do not go for unnecessary tests. Another way that SSP has impacted population health in California is by focusing on preventative care through coordination of services across the different levels of care (Milwee, 2020).

The concept of bundled care.

Bundled care is a concept that entails Medicare implementing voluntary episode of payment models.  Medicare used to make individual payments to individual services offered to patients. In Bundled care, all payments are combined in a single payment for physicians and hospital facilities. Bundled care increases the incentives for providers to work together to deliver patient care. Bundled care exposes healthcare facilities to certain risks and challenges. Some of the risks of bundled care include the fact that patients may have comorbidities (Agrwal, 2020). This is where some patients might require expensive treatment procedures that are uncontrollable by the provider. Another risk of bundled care in handling cases of uncompliant patients. When patients fail to comply with their care plan such as the medication regimen, health care providers will have difficulties in managing the costs.

Benefits of showing pricing for care.

One benefit of showing pricing of care is that it promotes price transparency. When there is access to price transparency, it helps them to choose accountable payment models that are implemented by different organizations to improve healthcare quality. Another benefit of showing care pricing is that it empowers patients to make informed decisions and get more involved in their care. Care pricing also ensures equitable prices for both insured and uninsured patients since in most cases the uninsured patients are often charged more (Mummadi & Mishra, 2020). Finally, showing care prices helps the patient to make decisions on which provider will be most effective at a low cost. Showing care prices increase competition in healthcare facilities thereby improving the quality of care provided.

In conclusion, the Shared Saving Program (SSP) is an accountable care organization (ACO) that is designed to improve population health as well as the quality of care to patients. Showing care pricing benefits healthcare in various ways. By showing care prices, patients can make an informed decision based on the pricing and quality of services offered.

References.

Agarwal, R., Liao, J. M., Gupta, A., & Navathe, A. S. (2020). The Impact of Bundled Payment On Health Care Spending, Utilization, And Quality: A Systematic Review: A systematic review of the impact on spending, utilization, and quality outcomes from three Centers for Medicare and Medicaid Services bundled payment programs. Health Affairs, 39(1), 50-57.

Lipa, S. A., Sturgeon, D. J., Blucher, J. A., Harris, M. B., & Schoenfeld, A. J. (2020). Do Medicare Accountable Care Organizations Reduce Disparities After Spinal Fracture?. Journal of Surgical Research, 246, 123-130.

McWilliams, J., Hatfield, L., Chernew, M., Landon, B., & Schwartz, A. (2016). Early Performance of Accountable Care Organizations in Medicare.

Millwee, B. (2020). Accountable Care Organizations in Medicaid. The Journal of ambulatory care management, 43(1), 11-14.

Mummadi, S. R., Mishra, R., & Mummadi, R. R. (2020). Price Transparency in the Electronic Health Record. Jama, 323(3), 281-281.

NURS 8100 Week 2 Discussion Unintended Consequences of Health Care Reform Sample

Discussion: Unintended Consequences of Health Care Reform 

The selected topic for this discussion is Accountable Care Organizations (ACOs). ACOs refer to networks of healthcare professionals who collaborate to deliver enhanced and more cost-effective treatment interventions to patients (Lewis et al., 2018). ACOs were instituted under the Medicare Shared Savings Program, a segment of the Patient Protection and Affordable Care Act (PPACA) of 2010. 

Positive results that could be achieved with ACOs include having cost-effective treatment services. The ACA incentive matrix was created to offset the trend of costs rising unreasonably under the traditional Medicare fee-for-service model. ACOs could reduce healthcare costs since ACO providers are ranked against a sequence of quantitative benchmarks that are modified to account for regional cost variations (Wilson et al., 2020). Besides, ACOs can realize substantial savings and maximize their Medicare incentives if they meet their agreements with the CMS. Nonetheless, individuals may face unintended consequences such as perceiving that they are stuck in an unfavorable network (Lewis et al., 2018). ACOs are created to lower this risk by getting rid of the structural barriers of the HMO system. However, some healthcare economists express concerns that consolidation may restrict options available to consumers. 

My current organization should consider unintended issues such as facing losses with regard to ACOs. Financial losses may occur because ACOs have savings to share if they fail to reduce the cost of care. Consequently, the organization’s operating budget may be affected because of the costs of investments used to improve care (Wilson et al., 2020). Besides, the organization may pay penalties if it fails to meet quality and cost savings benchmarks. Furthermore, the nursing profession should consider the quality of patient care with respect to ACOs. Healthcare providers who participate in an ACO must meet particular quality benchmarks, focusing on prevention and adequately managing patients with chronic diseases (Colla & Fisher, 2017). Thus, nurses who participate in an ACO must consider providing high-quality preventive care and management of chronic illnesses.   

References 

Colla, C. H., & Fisher, E. S. (2017). Moving forward with accountable care organizations: some answers, more questions. JAMA internal medicine, 177(4), 527-528. https://doi.org/10.1001/jamainternmed.2016.9122 

Lewis, V. A., D’Aunno, T., Murray, G. F., Shortell, S. M., & Colla, C. H. (2018). The Hidden Roles That Management Partners Play In Accountable Care Organizations. Health affairs (Project Hope), 37(2), 292–298. https://doi.org/10.1377/hlthaff.2017.1025 

Wilson, M., Guta, A., Waddell, K., Lavis, J., Reid, R., & Evans, C. (2020). The impacts of accountable care organizations on patient experience, health outcomes and costs: a rapid review. Journal of Health Services Research & Policy, 25(2), 130–138. https://doi.org/10.1177/1355819620913141