Health Care Delivery Models and Nursing Practice

Health Care Delivery Models and Nursing Practice

Health Care Delivery Models and Nursing Practice 150 150 Peter

Health Care Delivery Models and Nursing Practice

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1.Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
2.Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
3.Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
4.Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Sample Paper

Health Care Delivery Models and Nursing Practice

Over the years, healthcare reforms have been a significant part of the American healthcare system. The healthcare reforms include changes that address the ever-changing needs of patients and boost the benefits gained by citizens through healthcare delivery. Therefore, this paper will focus on changes introduced to restructure and reform the U.S healthcare delivery system and the role of nurses within the changing environment.

Current Law/Federal Regulation for Restructuring Healthcare Delivery

Regulations play a vital role in health insurance coverage. The diverse regulatory bodies are used to guard the public from several health risks and offer programs that boost the welfare and health of the public. Therefore, the healthcare standards and regulations are necessary to facilitate compliance and improve the quality of care for every individual accessing the healthcare system. One of the recent healthcare laws is the Affordable Care Act (ACA). The federal Affordable Care Act was signed in 2020. The key provisions of the ACA are intended to increase access to insurance, expand consumer protection, and emphasize wellness and health promotion through improved quality and system performance to eliminate the rising healthcare costs (Lee and Porell, 2020). The ACA expands health insurance coverage to over 32 million uninsured citizens through expanding public and private insurance. Consumer insurance protection increases through the prohibition of monetary caps and state-based rate reviews. The federal law also prevents illness and promotes wellness by establishing public health funds that offer grants for prevention activities, support training programs, and implementation of novel primary care models such as team management and medical homes (Lee and Porell, 2020). The key provisions of ACA that focus on curbing the increasing healthcare costs include the provision of more control over health insurance practices, especially premiums, reduction of health fraud, effective treatment in primary care, and new payment system models in Medicate and Medicaid.

ACA obliges nurses to carry on transformational leadership, care coordination, and innovation as major stakeholders in providing care for the next generation of quality advances, cost suppression, and increased patient access. The federal law has put greater focus on patient outcomes, which comes with more pressure on the role and responsibilities of nurses to demonstrate that they can offer effective care (Cleveland et al., 2019). Nurses are responsible for reducing healthcare costs by ensuring that they stay on budget, reduce waste, and create adequate staff schedules to prevent overtime hours. Therefore, nurses have been positioned to offer leadership in all healthcare sectors, including improving quality, reducing medical errors, increasing access to care, better care coordination, and eliminating workforce shortages to improve health and healthcare delivery.

Quality Measures and Pay for Performance

Studies have indicated that pay for performance and quality measures impact patient outcomes. Quality measures are standards utilized for measuring the healthcare performance of the care providers while caring for the patients (Hanefeld, Powell-Jackson, and Balabanova, 2017). The quality measures can examine significant aspects such as effectiveness and care safety. The quality measures are classified into outcome, structure, and process. The process measures offer evidence that encourages healthcare practitioners to follow the best practices that improve patient outcomes. The structural measures examine whether the healthcare organization has the capacity, processes, and systems that facilitate high-quality care. Outcome measures reflect the effect of healthcare services and how they influence the quality of healthcare delivery. When the quality measures are clinically relevant, the clinicians can understand a need to drive improvements in patient care. For instance, they can quantify the healthcare process, patient perceptions, healthcare outcomes, and organizational systems linked to the capability to offer high-quality healthcare.

On the other hand, the pay for performance systems is a payment model that attaches incentives to the care provider. This approach is established to rally healthcare quality through monetary incentives (Mendelson et al., 2017). Ideally, this strategy aims to adhere to best care practices by offering a financial incentive to healthcare practitioners. Through adherence to the clinical guidelines, healthcare providers boost patient safety and quality of care, resulting in better patient outcomes. Healthcare payers redirect funds to incentives and emphasize quality rather than quantity of care to boost best clinical practices and promote positive patient outcomes.

Pay for performance, and quality measures have promoted professionalism in nursing. Nurses have focused on patient satisfaction and patient-centered care services since they are responsible for positive patient outcomes in healthcare settings. Quality measures and pay for performance influence the nursing process and quality improvement efforts among nurses. For instance, nurses have taken measures within their scope to promote health and achieve the set care goals.

Professional Nursing Leadership and Management Roles

The emerging trends in promoting patient safety and quality care have been important in facilitating transformation in the American healthcare system. Nursing leadership management roles that have arisen to respond to the emerging trends and the need to promote quality care and patient safety include empowering patient decision making, innovation in problem-solving, supporting other nurses, and managing the provision of care (Black, 2019). The nurse managers have been mandated the nursing leadership and management roles to ensure that the working environment is healthy and safe and highly contributes to teamwork among nurses.

The nurse leaders have to improve the nursing outcomes and practices by leading initiatives that inspire the nursing team to develop patient-centered care and high-quality care approaches. For instance, the nurse leaders are now responsible for controlling and executing new care policies that focus on strategic planning with the nursing team. In contrast, the nurse managers focus on managing the nurse team and initiatives linked to patient care strategies. The nurse leaders and managers also have new responsibilities of developing systems that improve quality of care, coordination of care, reduce medical errors and increase access to care. They are required to partner with other healthcare professionals to innovate systems that improve the provision of care and healthcare outcomes.

Emerging Trends

The two major trends in which the nursing practice and nursing roles will transform and grow to respond to the upcoming trends and issues in health are artificial intelligence and virtual care. Artificial intelligence has allowed nurses to increasingly synthesize data, assist in clinical decisions and boost patient outcomes. Artificial intelligence will continue improving nursing practice by aiding nursing in making wide-ranging clinical judgments, educating them, and boosting their experience (Yu, Beam, and Kohane, 2018). AI technologies have promoted evidence-based and responsive nursing practice through offering decision support and cognitive insights. For instance, it has allowed nurses to visualize the patient trends that allow long-term management and planning.

Virtual care has allowed the integration of new digital technologies such as remote monitoring, telehealth, mobile device apps, telemedicine, and electronic health records that have enabled healthcare systems to increase their services to patients in a convenient manner (Schwamm et al., 2020). The healthcare reforms are focused on improving the quality and access of care. Virtual care technologies have facilitated the delivery of care in a remote locations. Nurses have delivered, coordinated, and managed care services that promote patient wellness. For instance, one of the greatest issues has been patient-centered care. Therefore, virtual care technologies will continue to support care delivery and better focus on the patient’s individual healthcare needs.


In summation, the healthcare reforms have greatly transformed healthcare practices and improved the care quality. The affordable care act is among the recent federal regulations focused on better access to care and quality care. Nursing responsibilities and roles have shifted to ensure that they achieve the goals of the Affordable care act. Quality measures and pay for performance have positively influenced patient outcomes and nursing responsibilities and roles by improving healthcare delivery processes and systems. Professional nursing leadership and management roles have increased due to the demands of the trends and healthcare reforms. Various trends have emerged due to health care reforms that require efficient systems and processes to improve quality and access to care. Virtual care and artificial intelligence technologies have been significant in improving healthcare delivery and addressing healthcare issues and trends.



Black, B. (2019). Professional nursing E-Book: Concepts & challenges. Elsevier Health Sciences. Available at:

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: harnessing the power of nurses. Online Journal of Issues in Nursing24(2). Available at:

Hanefeld, J., Powell-Jackson, T., & Balabanova, D. (2017). Understanding and measuring the quality of care: dealing with complexity. Bulletin of the World Health Organization95(5), 368. Available at:

Lee, H., & Porell, F. W. (2020). The Affordable Care Act Medicaid expansion affects disparities in access to care and health status. Medical Care Research and Review77(5), 461-473. Available at:

Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., … & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Annals of internal medicine166(5), 341-353. Available at:

Schwamm, L. H., Estrada, J., Erskine, A., & Licurse, A. (2020). Virtual care: new models of caring for our patients and workforce. The Lancet Digital Health2(6), e282-e285.