Consider the evolution of the U.S. health care system. Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse. Project what major evolving trends in the health care delivery system will affect nursing practice and how advanced registered nurses will influence the direction of health care.

Topic 1 DQ 1 Example

Solution Rosette The healthcare system in the U.S. keeps evolving and yet still fragmented, and compared to other countries, the U.S. has higher healthcare spending. According to HEOR (n.d.), the U.S. healthcare system can be defined as a mixed system, as there is no universal coverage. There is government funding, which includes Medicare and Medicaid, and privately financed or from private health insurance plans and out-of-pocket payments. In 2010, the Affordable Care Act (ACA) or “Obamacare,” or the comprehensive health care reform law, was enacted. Davalon (2022) stated that the ACA significantly changed the U.S. healthcare system by reducing the amount individuals and families paid for uncompensated care. The U.S. healthcare system began to experience a shift in how healthcare services are delivered and paid for after the ACA (Veradigm, n.d.). Many health care reforms have been implemented to emphasize quality of care over quantity (Veradigm, n.d.). According to Veradigm (n.d.), “Value-based healthcare is a healthcare delivery framework that incentivizes healthcare providers to focus on the quality of services rendered, as opposed to the quantity.” As The University of Michigan (2021) stated, the three main goals of Value-Based Care are often referred to as the triple aim: better care for individuals, improved public health, and lower costs. In addition, BVC acknowledges that “higher health care costs do not lead to better outcomes” and that provider workflow designed to maximize throughput can lower the quality of Care (U.M., 2021). BVC also promotes the kind of collaborative partnerships among providers, administrators, and patients that drive down costs while improving standards of Care (U.M., 2021). Comunale et al. (2021) stated that with the radical change in the healthcare system, hospital organizations had to evaluate new models of care that will support high-quality but low-cost care while maintaining timely patient access and reduced wait times. They stated that collaboration between physicians and Advanced Practice Providers (APPs) would be the key mechanism to providing care in the new care model. Nurse leaders have several roles to play in VBC; they can help expand the scope of advanced practice registered nurses’ practice across the U.S., reducing costs and expanding access to care (U.M., 2021)