Chronic Healthcare Management Policy

The Affordable Healthcare Act promotes preventative health care for Americans and in return increases the number of individuals taking improved measures of precaution when it comes to their health. The utilization of mid-level practitioners, such as nurse practitioners and physician assistants would progressively benefit the delivery of primary care. NPs and PAs are more cost effective, provide coverage for the increasing amount of new people requiring health coverage, and require less liability risk cost when compared to a physician’s rate. According to Shell (2013), “Partly driving this change is the Affordable Care Act (ACA) which will extend health care coverage to approximately 30 million more individuals, most of whom have not been

In 2010, President Barrack Obama signed the health care reform into law, the Affordable Care Act (ACA). Community-Based Collaborative Care Network Program is a part of the ACA which emphasizes primary care, funds community health initiatives, and promotes quality care for more coverage for those uninsured in the U.S. and is more cost-effective to generate billions of dollars in savings for the United States budget. Policy makers and public issues and concerns are growing on cost of health care, affordability and accessibility of health care, health care quality, development of sustainable solutions to health care problems, and promoting personal and community responsibility for health. Future nurses must be prepared to address today’s health

P., Halverson, P. K., Kaluzny, A. D., & Norton, E. C. (2001). How managed care plans contribute to public health practice. Inquiry - Blue Cross and Blue Shield Association, 37(4), 389-410. Retrieved from

According to the Henry J. Kaiser Family Foundation (2012), health and health care disparity refer to differences in the health and health care between population groups. The health disparity generally refers to a higher burden of illness, injury, disability, or mortality experienced by one population group relative to another. A health care disparity typically refers to the differences between groups in health coverage, access to care, and quality of care. While disparities are commonly viewed through the lens of race and ethnicity, they occur across many dimensions, including socioeconomic status, age, location, gender, disability status, and sexual

Flexible funding also aided in providing services for all of the unexpected services listed above, that were needed to adequately care for the Medicaid recipients (Sandberg et al., 2014). Without the flexibility to reimburse the additional professionals for their services, the patients would have received disjointed care that did not meet their total needs and would have negatively impacted their overall

By integrating patient engagement, coordination of care, quality of care, adopting health information technology and access to care, encouraging results in improving the quality of patient care, reducing hospitalization and ED visits were presented in some pilot projects mainly from integrated delivery systems and multi-payer sponsored PCMH initiatives. As the evidence is thin for the Medicaid population, especially for the people with disabilities, this dissertation presents timely and essential evaluation of the potential of the PCMH model in guarding against the explosion of Medi-Cal

The Affordable Care Act has shifted focus on health and wellness of patient populations urging hospitals to do a community needs assessment and come up with a strategy to address these needs. Hospitals most often partner with community and professional organizations to address the health need (Stempniak, 2014). This is an example of how the four spheres are all interrelated. Nurses are at the heart of this movement, providing the necessary skills, experience and expertise to address the needs of the population being served (Shamian,

It was developed by Wagner and his colleagues as a framework for guiding specific quality improvement strategies (Bowen et al., 2010; Fiandt, 2006). The goal of CCM is for productive encounters between patients and their healthcare professionals leading to care which is safe, effective, timely and patient focus, efficient and equitable (Institute of Medicine,2001; Wagner et al., 2001). The CCM consists of six core concepts (Appendix 1). Components related to the clinical practice level are: delivery system design, decision support, clinical information systems, self-management supports, and healthcare organization, leadership and community resources are related to the large health system. Chronic disease management can be centred on individual aspects or on the model as a whole, however, it is important to keep all components in mind (Bowen et al., 2010;

Kaiser Family Foundation (2012), health and health care despairs refer to differences in the health and health care between population groups. The health disparity generally refers to a higher burden of illness, injury, disability, or mortality experienced by one population group relative to another. A health care disparity typically refers to the differences between groups in health coverage, access to care, and quality of care. While disparities are commonly viewed through the lens of race and ethnicity, they occur across many dimensions, including socioeconomic status, age, location, gender, disability status, and sexual orientation (HKFF,

The need for population health management in our health care system is incredibly important. In order for our health care system to work there has been many different approaches in order to intertwine each system within the health care world. “Whether the goal is getting a handle on population health, taking on risk based contracts, or improving the patient care experience, hospital leaders and physicians are separately learning the same tough lesson- they can’t do it alone.” (Morrissey, 2015). With that said, clinical integration is the key changing our system.

INTRODUCTION In the United states(U.S) hospital care is the largest component of the health services which accounts for about 31% of all money spent on health care in 2005 (Catlin et al. 2005; AHA 2006).Contemporarily, enormous use of limited facilities by patients is the supplementary issue of the diverse mixture of hospitals, patients, market settings and financial resources have compromised the health care providers to strike a balance between efficiency and quality.(Woolhandler, and Himmelstein,2004; Coulter et al. 2000). A mix of public and private organization’s hospitals in the US in which Not-For-Profit (NFP) and For-Profit (FP) institutions are found. Healthcare organizations can begin either like FP or NFP.

Nurses are critical for promoting health in the society. The profession is highly flexible, since they specialize in diverse operations in the medical field. Registered nurses, for instance, are responsible for the administration of medicine and inoculations to patients (American Nurses ' Association, 2000). Additionally, these professionals observe, record, and enlighten doctors of any changes in a patient’s health. Nurses interpret and evaluate diagnostic examinations to determine an individual’s condition, as well as making the necessary adjustments in patient treatment plans on their health progress.

In the nursing profession there are numerous models of nursing care. Orem (2001) bases her care model on promoting and encouraging self-care and Roper-Logan-Tierney (2000) developed their model on the 12 basic activities of living. The aim of the Chronic Care Model is to transform the daily care for patients with chronic illnesses from acute and reactive to proactive,

This model is interesting because it is one of the most commonly used models and was created within the clinical setting. The Chronic Care Model (CCM) is primarily patient-focused and was created to improve the care of patients with chronic medical conditions by allowing the patient to have

The public policymaking process is the framework put together in order to develop, evaluate, and place policies in effect. The government goes through a series of phases in order to develop health laws and regulations for the general public. These phases are policy formulation phase, policy implementation phase, and policy modification phase. The model of the public policymaking process lays out the external factors of the public and helps to create a way to find which policies will work best for the majority of the public. The model makes sense because some type of framework work or strategy is needed, in order to make sure that policies are being passed fairly and that all factors are being taken into account while policies are being developed.