The Patient Protection and Affordable Care Act (ACA) passed in March 2010 is aimed at increasing access to health care for the 47 million people who were without health coverage and increasing healthcare quality and cost-effectiveness. 16 million of these people will be covered by ending the practice of insurance companies to place lifetime limits on coverage, will prohibit denial of coverage for preexisting conditions, will allow dependent children up to 26 to stay on parents’ policies and will provide financial assistance to income-eligible individuals and small businesses. The “individual mandate” is one of the most contentious provisions of the law which requires that most U.S. citizens and legal residents have health coverage by 2014 or face penalties.
The quality of care is expected to improve through removal of payment incentives for volume of services to a greater emphasis on value of services, health outcomes and fewer hospitalizations. “The goal is to provide the right patient the right care at the right time in the right place and at the right place.” The ACA expects to make preventive services and screening more accessible so that serious medical conditions may be discovered earlier and then be less costly to care for. Title 3 will require interdisciplinary teamwork focusing on transparency for better safety and quality, reduction of medical errors, preventable admissions and readmissions and healthcare –associated infections through benchmarking progress with special attention to those with chronic conditions and health disparities.
Nurses must be skilled users of health information technology to track how their work leads to quality outcomes and cost efficiencies. This has been at the core of nursing since “Florence Nightingale, during the Crimean War invented the polar-area diagram and pioneered the use of statistics and hospital reporting to improve nursing care.” The American Nurses Association developed the National Database of Nursing Quality indicators collects and evaluates unit-specific nurse-sensitive data from U.S. hospitals.
ACA has reauthorized and modernized Title 8 of the Public Health Service Act to Provide Advanced Nursing Education Grants, reauthorizes forgiveness of loan repayment and scholarship for three years of service in underserved locations and facilities, reauthorized loan programs to support the education of master’s and doctorally prepared nurses in exchange for teaching in accredited schools of nursing. The Nursing student loan program increases the total loan amount from $13,000 to $17,000 as well as expanding several other grant programs that expand the career ladder.
The provisions of ACA will be phased in over the next few years with “nurses participation in the law’s implementation being crucial for nurses to play a leadership role in improving healthcare and implementing healthcare reform.”
(adapted from Nurse.com – May 16, 2011)
