Journal of Professional Nursing
Volume 26, Issue 3 , Pages 133-134, May 2010

Transforming Our Nation's Health

Associate Editor, Policy, Professor and Dean, College of Nursing, The University of New Mexico

Article Outline

 

FASTEN YOUR SEAT Belts! Transformation of how we provide (and pay for) health care in the United States is underway. Passage of the Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act provides extraordinary opportunities for nurses. Some of the benefits for nursing are readily apparent: expansion of the National Health Service Corps, parity of payment for certified nurse midwives, expansion of faculty loan programs, increased funding for Title VIII nursing workforce development, lifting of the cap on grant funding available to doctoral programs, and recognition of Nurse-Managed Health Centers for eligibility for Federally Qualified Health Center status (HR 3590 Patient Protection and Affordable Care Act, 2010, HR 4872 Health Care and Education Reconciliation Act, 2010, American Association of Colleges of Nursing, 2010).

New and exciting additional provisions also include funding for evidence-based home visiting programs for at-risk families, a demonstration project for residency programs for nurse practitioners in community settings, the Graduate Nursing Education demonstration project to support advanced practice nursing residencies, and a prohibition for health plans or insurers from discriminating against health care providers on the basis of participation and coverage.

Perhaps even more transformative are provisions that do not specifically mention nursing but call for nursing to engage in creating solutions to transform care. These areas include the following:

•Accountable Care Organizations are being designed to cover overall care of a group of beneficiaries by using Health Information Technology at its fullest capacity, deploying all health workers to their highest and most functional levels and providing high-quality coordinated care. These organizations can increase quality while decreasing costs. A future we can create envisions nurses as major players in providing performance-based care and sharing in the risks and incentives attached to performance.

•Comparative Effectiveness Research is the conduct, support, or synthesis of research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, disorders, and other health conditions. Nurses can seek grant funding to compare different models of care.

•The Center for Innovation at Centers for Medicare and Medicaid Services will provide the venue to test innovative payment and models of service delivery to preserve or enhance quality of care while reducing costs. Preference will be given to models that improve the coordination, quality, and efficiency of health services provided. Nurses can bring forward and test the models that we have developed and create new ways of approaching complex system issues.

Some of us are taking “a wait and see” attitude, unconvinced that health reform will actually become reality (Center to Champion Nursing in America, 2010). The broken system we currently know can seem more comfortable than the one that has yet to be created. The course is yet to be charted, and no doubt, many detours lie ahead. This unprecedented moment offers our profession a golden opportunity to improve the health of our nation by helping to create a system that nurses know will meet the needs of our population.

A wise person once said, “The best way to predict the future is to create it.” Now is the time for nursing to create a new future. This new future includes ideas such as all health care providers functioning at their highest level of education and expertise without artificial regulatory barriers, health care being valued over disease care, and chronic disease management and transitional care are normative, not exceptional.

The future health care system that we are creating begs for a health professional who works in teams, provides continuity of care, and coordinates and facilitates care transitions. Nurses are poised to improve access and quality while decreasing costs of care. Some will say that I am describing some sort of a “superhero.” I believe I am describing what is best about nursing. This is our opportunity to truly transform the health of our nation. The path is not clear, the road has not been built, and there are many detours ahead. The window of opportunity is now. We can create the road map! There is no doubt that hard work lies ahead. We must grapple with complex questions. How can we create an ecosystem that optimizes the benefits that nursing brings to society? What curricular changes, clinical and simulation experiences, community engagement pathways, and research trajectories need to be created to manifest our future?

The future is ours to create. Let's get going with this very important work!

Back to Article Outline

References 

  1. American Association of Colleges of Nursing . Healthcare Reform. Retrieved April 16, 2010, from www.aacn.nche.edu/Government/pdf/HCRreview.pdf2010;
  2. Center to Champion Nursing in America . Nurses integral part of new health care reform law. Retrieved April 12, 2010, from http://championnursing.org/blog/2010-04/nurses-integral-part-new-health-care-reform-law2010;
  3. HR 3590 Patient Protection and Affordable Care Act (2010). Retrieved April 12, 2010, from http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3590enr.txt.pdf. United States Congress (2010).
  4. HR 4872 Health Care and Education Reconciliation Act (2010). Retrieved April 12, 2010, from http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h4872enr.txt.pdf. United States Congress (2010).

PII: S8755-7223(10)00040-2

doi:10.1016/j.profnurs.2010.04.002

Journal of Professional Nursing
Volume 26, Issue 3 , Pages 133-134, May 2010

Article Tools