NURS 8100 WEEK 7 Healthcare Reform Interview

Walden University NURS 8100 WEEK 7 Healthcare Reform Interview– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8100 WEEK 7 Healthcare Reform Interview 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 7 Healthcare Reform Interview

Whether one passes or fails an academic assignment such as the Walden University NURS 8100 WEEK 7 Healthcare Reform Interview 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 7 Healthcare Reform Interview

The introduction for the Walden University NURS 8100 WEEK 7 Healthcare Reform Interview 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 7 Healthcare Reform Interview

After the introduction, move into the main part of the NURS 8100 WEEK 7 Healthcare Reform Interview 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 7 Healthcare Reform Interview

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 7 Healthcare Reform Interview

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 7 Healthcare Reform Interview

Reforms remain a critical part of the U.S. health care system with changes occurring at different levels of government, from state to federal system, to ensure that all Americans have access to health care. Healthcare reforms have influenced the healthcare delivery process in the U.S positively; though, some undesired negative consequences have also emerged. I conducted an interview to discuss the healthcare reforms with my state senator. The identified health issue is the use of innovative care models like the accountable care organizations (ACOs). The purpose of this paper is to provide highlights from the interview and an analysis of the same. The interview had two parts based on the questions and its analysis. 

Part 1 

1. How would you rate the current healthcare system in terms of quality care delivery? 

2. Do you think the introduction of ACOs has influenced the quality of care delivered to the patients in any way? 

3. What are some of the challenges encountered in the implementation of affordable care programs? 

4. Do you think the Medicare and Medicaid programs have achieved their intended purposes of reducing the cost of treatment? 

5. What are the ethical considerations and implications of punishing healthcare institutions with more readmissions within 30 days than the recommended numbers? 

The questions aimed at understanding the current healthcare reforms with the main focus being on the Medicare and Medicaid programs. There are many reforms witnessed in the healthcare sector; though, the Medicare and Medicaid programs are easily noticeable. Besides, the questions would help in determining whether the programs have achieved their intended purposes and the existing gaps that need to be addressed. The question of whether Medicare and Medicaid programs have achieved the intended goals is complex and can be analyzed from different perspectives. In one way, it may be true that the government has done its mandate to offer affordable healthcare programs, especially to vulnerable populations and so it is the mandate of the healthcare providers to offers high-quality services. On the other hand, it may be seen that the government has not implemented the program effectively and has resulted in increased pressure for the healthcare providers. Finally, the questions also analyze the ethics governing the healthcare reforms.  

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Part 2 

Analysis of the Interview 

Exploring the healthcare reforms provided an opportunity for understanding the dynamics in the healthcare delivery processes. The cost of care delivery remains a major challenge for the majority of the population, especially with the rising cost of living. Various measures and policies have been developed to promote universal health coverage and ensure that all people receive quality healthcare services in time. Inequalities in access to healthcare services are associated with the rising cases of cardiovascular diseases and the associated mortalities. The interview session was effective as the selected national leader was open to discussing the critical issues in the current system and the new approaches to adopt in making access to healthcare services better.  

One of the key factors covered in the interview was the implication of the Medicare and Medicaid programs on the cost of medication. The Center for Medicare and Medicaid Services continues to have a strong influence on the healthcare delivery processes through financial incentives and reimbursements. One of the incentives would involve rewarding those that offer quality care and punishing the poor performers based on the specific quality indicators such as readmission within 30 days of discharge. On the other hand, such policies tend to limit the ability of healthcare providers to offer comprehensive care to patients. Besides, there are cases where the cost of care has increased instead of reduced. The concern in covering the topic during the interview was to understand the critical factors contributing to the high cost of medication and how they could be addressed despite having the Medicare and Medicaid programs.  

The interviewer acknowledged that there were cases when the expenses in the Medicaid and Medicare programs would rise. The rise would be witnessed during the economic downturn because many people enroll in the program after losing jobs. The state has to struggle to keep up with the rising cost of healthcare and so may be forced to increase the tax to cover the high budget (Joynt Maddox et al., 2019). Alternatively, the interviewer reported that the state could manage the costs by cutting the payment rates and to the healthcare providers; though, this makes it harder for the healthcare providers to offer quality services to the patients (Shrank et al., 2021). Healthcare facilities require adequate resources to manage the patients accordingly. The reforms and policies developed should be guided by the quadruple Aims which cater to both the needs of the patients and their healthcare providers.  

Also, there was the need to explore the oversight of managed care and how it could be improved. It is evident that a majority of the Medicaid enrollees get care through privately managed care firms. Therefore, the main concern is on how the companies can improve costs and maintain quality healthcare services. The compensation given to the healthcare providers should be able to motivate them to offer the best healthcare services to their patients. The interviewer indicated the need to prioritize quality and continuous quality improvement processes. Such initiatives will ensure that patient stays for a few days in the hospitals. The healthcare providers will focus on offering self-care competencies among the patients which will, in turn, increase their level of independence and reduce cases requiring readmissions. Focusing on high-quality care delivery and creating an environment of safety will compel the health care providers to offer the best care to the patients willingly and reduce the burden on the government to pay for the high costs of treatment (Warner et al., 2020).  

The last component of the discussion during the interview focused on the ethical issues and implications of the healthcare reforms, especially, the financing aspects. For example, what are the implications of forcing the healthcare providers to reduce medication costs while at the same time, they have to offer quality healthcare services (Yan et al., 2021)? Also, are some of the policies meant to punish healthcare providers for not offering high-quality services justifiable? For example, the health institutions have been punished for high cases of readmissions within 30 days. Such measures are important; though, in one way, they seem to be too harsh on the healthcare providers.  

Finally, the interview session was educative and enriching. There was a lot to learn from the interviewer as far as offering quality healthcare services is concerned. Besides, it was evident that the government should focus on promoting a safe and quality working environment that will motivate quality care services to the patients.  

Conclusion 

Innovative care delivery models like the accountable care organizations (ACOs) aim at lowering the cost of care and ensuring that individuals get better interventions, especially primary care. The interview and its analysis demonstrates the need for the health system and providers to lobby policymaker at state and federal level to institute policies and reforms that will build on the present care delivery. The need for better outcomes implores on providers to seek better ways to offer care and meet diverse patient needs.  

References 

Joynt Maddox, K. E., Bauchner, H., & Fontanarosa, P. B. (2019). US health policy—2020 and beyond. JAMA, 321(17), 1670. https://doi.org/10.1001/jama.2019.3451 

Shrank, W. H., DeParle, N., Gottlieb, S., Jain, S. H., Orszag, P., Powers, B. W., & Wilensky, G. R. (2021). Health costs and financing: Challenges and strategies for a new administration. Health Affairs, 40(2), 235-242. https://doi.org/10.1377/hlthaff.2020.01560 

Warner, J. J., Benjamin, I. J., Churchwell, K., Firestone, G., Gardner, T. J., Johnson, J. C., Ng-Osorio, J., Rodriguez, C. J., Todman, L., Yaffe, K., Yancy, C. W., & Harrington, R. A. (2020). Advancing healthcare reform: The American Heart Association’s 2020 statement of principles for adequate, accessible, and affordable health care: A presidential advisory from the American Heart Association. Circulation, 141(10). https://doi.org/10.1161/cir.0000000000000759 

Yan, C., Liao, H., Ma, Y., & Wang, J. (2021). The impact of health care reform since 2009 on the efficiency of primary health services: A provincial panel data study in China. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.735654 

NURS 8100 Week 8 Discussion Policy and State Boards of Nursing

Regulations Promulgated through Maryland Board of Nursing. 

In the state of Maryland some of the advanced practice registered nurses (APRNs) include certified midwives, nurse anesthetist, certified nurse practioner (NP) and a clinical nurse specialist. This should be similar to other states too. At a minimum and from personal experience Maryland board of nursing has to give permission to practice as an NP and there are basic requirements that have to be met to qualify to be certified. Not all the regulations that are set forth by the state of Maryland for APRN to practice are recent but they are however all currently used. 

Code of Maryland regulations (COMAR) are the compilation of the state of Maryland regulations that help govern the state, (Maryland.org, n.d). Health care is not an exception and APRNP have to abide by the COMAR regulations. According to COMAR, (2020), APRNs can perform multiple functions independently. These include comprehensive assessments, complete a death certificate, do not resuscitate orders, interpret diagnostic and laboratory tests, prescribe medications, provide care and give referrals to other providers. An NP can also practice as a registered nurse and for those who have certifications for mental health, they can admit a client on an involuntary basis for treatment. 

How State Regulations Are Supported within Place of Employment 

The place of employment has set standards at the same level of practice as expected by the state but for some treatment approaches the expectation is to defer to the primary physician or the medical director.  Establishing this baseline helps achieve the expected standards and also remain in compliance with the COMAR and federal regulations. The place is very supportive that when the NP completes an admission assessment, the doctor does not have to double check unless there is a concern. 

As a nurse practioner, at the place of work there are multiple activities that can be performed independently. These tasks include but not limited to giving orders for medications and treatment, reviewing diagnostic tests, and responding to families as required. One task that is permitted by the state of Maryland but not encouraged at the place of work is signing of certificates of incapacity. (A. Speer, personal communication, July 26, 2021). The primary physician and the psychiatrist sign the Maryland order for life sustaining treatment (MOLST) also and only encourage the NP to sign it if they are not available. This is a task that is authorized by COMAR regulations. 

How States Differ in Terms of Scope of Practice 

Different states have different prescriptive authorities and conditions that they give to their APRNs. There are those states that are referred to as independent states which allow APRN independent prescribing and there are those which do not, (Schirle & McCabe, 2016).  Barriers to practice are not uncommon even when the states are flexible, health care settings can still impose different strict policies and procedures. This leads to restriction of some aspects of patient care and limited access to providers despite the states having full practice authority, (Schorn, Myers, Barroso, Hande, Hudson, Kim & Kleinpell 2022). 

Impact on Professional Nurses across the United States. 

Some nurses have opted to relocate or work where there is more prescriptive authority. Some nurses also have opted not to relocate but get licensures in neighboring states that can give them more autonomy. There are also nurses who have opted to work in other areas where they are needed. These areas include working as lobbyists, researchers, nurse educators and consultants. In this aspect their full potential is more effectively utilized. 

References 

COMAR 10.27.07.00 (2020) Practice of the Nurse Practitioner​ , http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm 

Maryland.org (n.d), Division of state documents. http://www.dsd.state.md.us/COMAR/ComarHome.html 

Schirle, L., & McCabe, B. E. (2016). State variation in opioid and benzodiazepine prescriptions between independent and nonindependent advanced practice registered nurse prescribing states. Nursing Outlook, 64(1), 86–93. https://doi.org/10.1016/j.outlook.2015.10.003 

Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy, Politics & Nursing Practice, 23(2), 118–129. https://doi.org/10.1177/15271544221076524