Re:Health Care Reform and Nursing

Re:Health Care Reform and Nursing


In general, the “medical home” (or “health home” both terms are used) can be understood as a mechanism to provide patients with a central primary care practice or provider who coordinates the patients’ care across settings and providers. This might be promoted through a capitated payment or other financial incentive to providers to encourage preventive care and chronic care management, as well as reduce reliance on specialist and emergency care. PPACA authorizes HHS to provide grants to or contract directly with states or state designated entities to establish community based interdisciplinary, interprofessional teams ( ‘‘health teams’’) to support primary care practices, including obstetrics and gynecology practices. The teams also must agree to provide services to eligible individuals with chronic conditions. The interdisciplinary, inter professional providers comprising a health team may include medical specialists, nurses, pharmacists, nutritionists,
dieticians, social workers, behavioral and mental health providers (including substance use disorder prevention and treatment providers), doctors of chiropractic, licensed complementary and alternative medicine
practitioners, and physicians’ assistants Medical/health homes are similar to ACOs in that they must meet statutory requirements that emphasize care and services squarely within nursing’s scope of practice; nurses will be acknowledged, indispensible leaders and members of the health team. A health team must, among other obligations, support patient centered medical homes. This is defined in PPACA as a mode of care that includes personal physicians; a patient centered, whole person orientation; expanded access to coordinated and integrated care; safe and high quality care through evidence informed medicine; continuous quality
improvements; and payment that recognizes added value from the additional components of patient centered care.
The law views “patient centered care” as incorporating...

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