Question

The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials: "About the Affordable Care Act" "Health Care Transformation: The Affordable Care Act and More" What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

Answer 1

The Affordable Care Act (ACA) expands access to coverage to millions of Americans, a goal health plans have long supported, but major provisions will raise costs and disrupt coverage for individuals, families, employers, and Medicare and Medicaid beneficiaries. The broad market reforms outlined in the ACA take effect on January 1, 2014. Individuals and families purchasing insurance in the individual market will be guaranteed coverage for pre-existing conditions, and their premiums cannot vary based on their gender or medical history. There will also be subsidies to help consumers afford the cost of coverage, and new health insurance exchanges will help consumers find the policies that best meet their needs.

The most important elements of Affordable Care Act in relation to community and public health is that it establishes a Public Health Workforce Loan Repayment Program to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. Under the program, HHS will repay up to one-third of loans incurred by a public health or health professions student in exchange for that student’s agreement to accept employment with a public health agency for at least three years. Individuals who serve in priority service areas may be eligible for additional loan repayment incentives at the Department’s discretion.

Community Health Centers are patient-directed organizations that serve populations with limited access to health care.Approximately 1,200 health centers operate more than 9,000 service deliveries sites nationwide and serve more than 21 million patients annually. Health centers focus on comprehensive care coordination, the ability to manage patients with complex healthcare needs, the use of quality improvement practices, and health information technology.

Public Health Service Act establishes the Federally Qualified Health Centers (FQHCs) to support the provision of primary care services in underserved urban and rural communities.

The role of the nurse in implementing this law-

Health care costs have been rising, quality of care issues must be addressed, and equity of healthcare access needs to be improved. For these reasons, though there is disagreement about some aspects of reform, most Americans agree that healthcare delivery systems in the United States require significant restructuring and improvement. ANA has long been a strong advocate of health care reform, and many of the provisions of the Affordable Care Act (ACA) align with ANA’s Health System Reform Agenda.

• The health center model uses a team-based approach that uses nurse practitioners, midwives, nurses, and many other healthcare providers. Since the ACA, community health centers have added over 4,500 nursing positions nationwide.
• A FQHC furnishes services by a nurse practitioner, certified nurse midwife, visiting nurse.
• As the largest single group of clinical health care professionals within the health system, registered nurses are educated and practice within a holistic framework that views the individual, family and community as an interconnected system that can keep us well and help us heal. Registered nurses are fundamental to the critical shift needed in health services delivery, with the goal of transforming the current “sick care” system into a true “health care” system.
• Registered nurses’ contributions to care coordination have long been a core professional standard and competency for RNs. It is what nurses do. It is what we have always done. Whether developing care plans guided by patients' needs and preferences, educating patients and their families at discharge, doing their best to facilitate continuity of care for patients across settings and among providers, RNs make coordinated care possible.