Workers can opt out and as an alternative obtain coverage from their state's insurance exchange. The PPACA standards will considerably affect industries that employ part-time, provisional, seasonal and float-pool workers at length (Clarke, Keckley & Kraus, 2012)
In fact, I suggest you to consider strengthening the act. "Although the United States continues to overspend on health care compared to its peer countries, international studies of health care quality suggest that the United States health care system is underperforming," (Whitehouse, 2012, p
This change will be extreme and may have to be addressed by not only more primary care physicians but also advanced practice nurses, such as nurse practitioners and physicians assistants, nurse midwives and even naturopathic physicians who currently have limited (if any) practice rights in most states. These new consumer demands will likely increase the demand for providers, outside of physicians and will also likely drive alterations in laws to expand the practice rights of alternative providers in many states (Carlson, 2010)
Under the new law (PPACA) many of those individuals will have insurance coverage and therefore seek care more frequently. According to one source hospitals will be seeking to increase staffing of doctors by twice or more (Zolkos, 2011)
Without the individual mandate, the other provisions of the Act would have been unenforceable, even if provisions such as the prohibition of discriminating against patients with preexisting conditions had been upheld. The individual mandate requires all Americans who can afford to do so to purchase some form of health insurance, with a "minimally comprehensive policy" if they are not covered by private or government-provided insurance (such as Medicaid, the federal and state-run program for the indigent and Medicare, the federal insurance program for the elderly) (Klein 2010)
The mandate is there to bring healthy people into the pool, which keeps average costs down and also ensures that people aren't riding free on the system by letting society pay when they get hit by a bus" (Klein 2010). Without the requirement that everyone possess insurance, fewer healthy people would buy insurance, persons with coverage would be sicker on average, and "this 'adverse selection' would drive up premiums, which in turn would cause even more healthy individuals to drop coverage -- possibly leading to a so-called 'death spiral'" (Tanden & Spiro 2012: 3)
The acts that the government has drafted and implemented have various initiatives that drive them. These initiatives include reducing costs and so as to make access to health affordable and protecting the consumers (Parks, 2012)
Another part of the act is that which will ensure transparency and program integrity. Under this, the health program will provide information to the public on the health systems available and in addition promote implementation of new set of requirements to curb fraud and abuse in both private and public programs (Wolper, 2004)
The second provision is about quality of nursing home transparency in order to enhance the quality of care in nursing homes. The provision will contribute to improved accountability of nursing homes through disclosure of the identities of their owners and operators (Brody & Sullivan-Marx, 2012, p
An example of an innovative care delivery model is The Nurse Caring Delivery Model at MetroWest Medical Center. This model is a team-oriented primary nursing structure for providing healthcare services in inpatient and outpatient settings (Joynt & Kimball, 2008)
That the nursing community has been able to incorporate the legislation at all given its scope and complexity is a testament to the level of preparedness and eagerness of ongoing improvement and providing a fix to the broken healthcare system is in the nursing community. More impressive is the fact that, while there is still a long way to go, there has been a discernible impact on the use of research and evidence-based practices from nursing fields on social policy and social work (Berkman 2011)
The research is not entirely conclusive at this point, which is hardly surprising given how recently the legislation was passed and even more recently it began to be implemented in any meaningful and functional way. It demonstrates, however, that the nursing community as well as other medical practitioners and researchers are noting the potential impacts of the legislation and are already attempting to implement changes (Dailey 2011; Webb & Marshall 2010; Newman 2011; Shelton & Saigal 2011; Berkman 2011)
In a variety of ways, then, the National Quality Strategy that has been created as called for in the PPACA directly impacts the practice of nursing and the use of evidence-based practices. Evidence of Impact on Nursing Practice Though a great deal of attention has been paid to the financial impacts of the PPACA as a whole in the year since it was signed into law -- and to the potential financial impacts that are expected to occur when all of the provisions of the law come into effect, if the law is not struck down first -- there has also already been some investigation as to the impact of the legislation on the practice of medicine and nursing (Groszkruger 2011; Dailey 2011)
The PPACA is not solely concerned with improving access to healthcare and the affordability of care, however; the legislation contains directives and policy measures aimed at directly improving the overall quality of healthcare throughout the country through explicitly empirical means. One of the most significant pieces of the PPACA in this regard is the call for a National Health Care Quality Strategy and Plan, created by a select council headed by the Surgeon General and under the auspices of the Department of Health and Human Services (McCurdy 2010)
The National Quality Strategy cannot claim all of the credit for this, to be sure, but the institution of a direct national mandate for increased reliance on evidence-based practices is certainly a step in the right direction. Evidenced-based practice in nursing has been part of a major push by the National Institute of Health and other federal agencies for quite some time, but the passage of the PPACA and specifically the development of the National Quality Strategy have done a great deal to cement this drive and to call for explicit ways in which to bring a greater use of evidence-based practice about (Melnyk & Fineout-Overholt 2010; NSQIHC 2011)
It is through this strategy that much of the direct impact of the PPACA on nursing can be seen. There are of course many pieces of the PPACA that will impact the practice of nursing, and that in some ways already are (Webb & Marshall 2010; Newman 2011; Groszkruger 2011)
All health care spending will reach $4.64 trillion in 2020, nearly half of which will come from government sources" (Fleming 2011)
Although some of the provisions of the ACA are popular, even amongst the president's opponents (such as the allowance for young adults who have been particularly hard-hit by the recent recession to remain covered by their parent's insurance) the most controversial aspect of the new law is clearly that of the individual mandate. The mandate states "all individuals who can afford health-care insurance purchase some minimally comprehensive policy" (Klein 2012)
Great Britain, Japan, Taiwan, Switzerland and Germany -- spend roughly half as much on health care as the U.S. spends, and have better outcomes" (Swenson 2009)
Also, they will have to deal with an even larger nightmare with regard to coordination of benefits between Medicaid/Medicare and private insurance and pressures to increase the quality of care while dealing with larger case loads and lower reimbursement levels. In addition, increased pressures on the hospital infrastructure can not be a good factor (Grogan, 2011, 1201)