How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurs

How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurs

How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse

Topic 1 DQ 1

The shift to value-based healthcare has become a prominent part of effective care delivery and affects the roles and responsibilities of advanced practice registered nurses (APRNs). Value-based healthcare is a delivery model that focuses on healthcare provider’s enhancing quality patient outcomes as opposed to having many patients so that they can get reimbursement from the Centers for Medicare and Medicaid Services (CMS) (Lowe, 2018). The model replaces the common fee-for-service where a provider’s reimbursement is based on the amount of healthcare service they offer or deliver. A primary goal of value-based healthcare is to contain the cost of care through elimination of certain expenses and focusing on patient’s illness and injuries. The model also promotes fast and full recovery from diseases as ways of readmissions and chronic conditions that lead to increased costs (Comunale et al., 2021). These aspects have significant impact on the roles and responsibilities of APRNs, especially nurse practitioners who are primary care providers and play a huge role in prevention of hospital admission through diagnosis, treatment and management of acute and chronic diseases in outpatient settings. These changes imply that the nurse practitioners should focus on value care as opposed to quantity to enhance patient satisfaction, reduce overall costs, and improve outcomes. NPs in primary care facilities can reduce hospitalizations, medical tests and processes to enhance patient health and health care costs.

How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse
How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse

The trends that will continue to define care delivery include shift to value-based models and increased demand for nurse practitioners

as primary care providers. Patient satisfaction will also affect the reimbursement as they will remain the key customers for NPs (Comunale et al., 2021). The NPs will continue to impact patient satisfaction through effective reimbursement and improvements leading to a demand in their services across the healthcare continuum. NPs will shift to patient-centered care as their roles expand and become primary care providers. how the shift to value-based health care has impacted delivery of care

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How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse References

Comunale, M. J., Lerch, W., & Reynolds, B. (2021). Integrating Advanced Practice Providers

into value based care strategies: One organization’s journey to achieve success through inter-professional collaboration. Journal of Inter-Professional Education & Practice, 22, 100384. https://doi.org/10.1016/j.xjep.2020.100384

Lowe, G. (2018). Value-Based Healthcare. The Journal of Nurse Practitioners, 14(3): 210. DOI:

https://doi.org/10.1016/j.nurpra.2018.02.012

According to health statistics in the United States of America in the period, 1960 and 2019 the health care cost increased from 5% to 17.7%, reaching 3.8 trillion dollars in 2019 (Harrill & Melon, 2021). So, the payment reform model reviewed the quality and health care expenses. Today current healthcare reform focused on Value-Based Healthcare (VBH) by using pay for performance (P4P), and alternative payment models (APM). In value-based health care, the focus is on the quality of patient care and helps the patients to be a partner in the process of future value in healthcare. Shifting to value-based healthcare has impacted the delivery of care through the participation of healthcare consumers, patient experience, recommendations, access, and outcome.

The role of an advanced registered nurse is important to deliver value-based health care. In this, the core value is the quality of care than the volume of care. APRNs must aim at how to provide health care cost-effectively and prevent and maintain chronic diseases. Considering the Participation of patients and their recommendation, interests, and values play a vital role in high-quality health care.

One of the major trends reflected in healthcare delivery due to covid-19 pandemic is telehealth and telehealth medicine. It was only used in rural and urban areas to provide health care before the pandemic, covid 19. Telehealth expanded nationwide during the pandemic to deliver care both inpatient and outpatient (Frey & Chiu, 2021). It provides same-day and chronic disease care appointments to increase safe practice by avoiding exposure to infectious agents, especially coronavirus. It helps advanced registered nurses to deliver high-quality and safe care through the advancement of technology. It enhances communication through video calls and improves patient outcomes. In addition, it is cost-effective and high-quality health care.

How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse References

Frey, M. B., & Chiu, S.-H. (2021). Considerations When Using Telemedicine As the Advanced Practice Registered Nurse. Journal for Nurse Practitioners, 17(3), 289–292. https://doi-org.lopes.idm.oclc.org/10.1016/j.nurpra.2020.11.011

Harrill, W. C., & Melon, D. E. (2021). A field guide to U.S. healthcare reform: The evolution to value‐based Healthcare. Laryngoscope Investigative Otolaryngology, 6(3), 590–599. https://doi.org/10.1002/lio2.575

NEJM Catalyst (2017) defines value-based healthcare stating, “a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes”. The goal of this system is patients achieve better health paying less money, providers have higher patient satisfaction, payers control costs and reduce risk, suppliers match prices depending on patient outcomes, and society becomes healthier (NEJM Catalyst, 2017). As an advanced practice nurse following a value-based health care, you are more focused on preventative care to avoid chronic issues and recovering as quickly as possible from any illnesses.

The University of Texas at Austin’s Dell Medical School is currently shifting their medical students to a value-based health care delivery system. They are taught value-based health care through UT Health Austin’s affiliated clinics. Teisberg et al. (2020) discusses how these clinics are organized stating, “segments of patients with shared needs and designed to provide comprehensive solutions delivered by interdisciplinary, outcomes-focused teams”. The goal of this set up is to provide patients with common concerns all resources they need in one area for quick recovery. The overall focus is the patient and how to best help in each stage whether preventative, recovery, or managing any long-term concerns.

The role of the advanced practice nurse varies depending on what each nurse specializes in such as ARNP, education, or in a leadership position. A nurse practitioner will be working as the coordinator in a PCP position or on an outcomes-focused team who specializes in a specific patient concern. An advanced registered nurse in an education position will either be teaching new nurses the ways of nursing, involved in educating patients on preventative measures, or educating patients with chronic conditions. An advanced registered nurse in a leadership position will be in charge of making sure everything is running smoothly and putting the needs of patients first. Nurses, as a whole, look at each aspect of a patient (physical and mental). The value-based system benefits nurses because its not just focusing on the physical problem but any mental problems and barriers to receiving appropriate care. The overall goal is the patient and nurses excel at focusing on the patient.

References

NEJM Catalyst. (2017). What is value-based healthcare? https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558

Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: A strategic framework. Acad Med, 95(5), 682-685.

How the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.
  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)
  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition
  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

 The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

 The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.