Cost, Access, and Quality for APNS

Answer

    Cost, Access, and Quality for APNS

The United States has continued to grapple with the issue of healthcare access, the growing costs of healthcare, and access to the quality of the healthcare provided. Joel (2018) posited that cost, access, and quality are closely related when it comes to attaining positive health outcomes to patients. Evidence based studies have revealed that the Advance Practice Registered Nurses (APRN) have played a significant role in reducing cost, improving healthcare access, and considerably improved the patients’ outcome (Joel, 2018). However, many concerns have been raised that consumers have been discontented with the present healthcare system, particularly in relation to the quality of care being offered. These concerns can be addressed through quality measures. By adopting quality measures into practice, the nurse practitioners will be accountable to the public, improve the outcome of patients and reduce morbidity and mortality.

Access to Care

            Healthcare access refers to a process in which one can easily obtain care and other benefits related to healthcare (Joel, 2018). Although some patients easily access healthcare benefits through state aid, their employers, private pay insurance or Medicare, many who sufficient healthcare are still viewed as underinsured. Underinsured patients are persons who are unable to raise the money required for co-pays or surpass their limits on their coverage. According to Holley (2016), some of the patients experience hindrances to healthcare such as lack of access to insurance, having trusted primary care providers, as well as, their view of the healthcare, as well as what patients think when compared to the real need for the quality healthcare.

Cost

             Joel (2018) contended that, the aim of the healthcare quality and insurance is to safeguard patients from the growing costs of accessing the quality care they need. According to the reading, accessing quality healthcare entails three major steps that include applying for and reaping insurance benefits,  designing a new office where patients can be assessed for their various healthcare conditions and developing trust and good communication rapport with the provider (Spagnola, Dickerson, & Harper, 2019). Accessing quality healthcare is critical to a patient’s positive outcome and cost. Reportedly, nurse practitioners can attain cost effectiveness by administering impartial treatment to everyone, spending significant amount of time with patients while educating them on their disease process, requesting only necessary tests, and having full nursing authority so that they can practice independently in the remote areas to bridge the gap of aged practitioners and treating the underinsured and uninsured.

            In the year 2017, the healthcare cost across the US rose to $3.5 trillion, a figure that made the healthcare to be regarded as one of the largest sectors across the US (Joel, 2018). It is worth noting that the stated figure only includes the American citizens and ignored illegal immigrants or those on visit. The healthcare costs in the US as contended by Joel (2018) include costs on insurance, provider services, supplies and goods, research education, pharmaceuticals, institutional costs and core public health services.

Quality

            Nurse practitioners work in an environment that is suitable for care their patients receive. When nurse practitioners receive adequate support from the management in terms of adequate resources and enough support staff, they are able to manage their stress effectively. This statement concurs with a report by Joel (2018) that the efforts that an organization puts to provide adequate resources and staffing improve the growth of personal resources among nurses and foster the responsibility of nurses for their personal health and are regarded as proper strategies for patient outcomes and nursing quality. As explained in the chapter, quality refers to how effective the services improve chances for preferred outcomes, evidence based and knowledge based (Joel, 2018).

            Reportedly, accessing care and receiving health care services entails myriad of components. As reported by Holley (2016) accessing quality care entails various steps including attaining insurance coverage through employers or other means, the ability to have access to healthcare at a given location and gaining access to healthcare provider that patients can trust, access to prescriptions and oral care. Principally, a greater percentage of the US citizens are either underinsured or lack coverage completely. A survey conducted in the year 2016 revealed that the number of Americans uninsured from 27.2 million to 28 million (Holley, 2016). Accessing healthcare insurance is very important and when sufficient insurance coverage lack, the patients are likely to experience poor health outcomes. However, it is important to note that poor health outcomes is not only contributed by lack of healthcare insurance but can be caused by other factors such as inadequate resources as in the case of psychiatric health care setting.

            Many studies have revealed that patients treated by nurse practitioners experience almost the same healthcare outcomes as those treated by physicians (Spagnola, Dickerson & Harper, 2019). A major reason that has made nurse practitioners to keep the healthcare cost low is because they treat whole patient by using the holistic approach of addressing the needs of the body, mind and spirit while at the same time taking into account psychological factors such as family support (Spagnola, Dickerson, & Harper, 2019). This implies that when nurses combine educating patients with a treatment plan, the likelihood is a positive patient outcome. The patient equally well aware of the treatment plan and as such, they are likely to adhere to these plans and prescriptions given to them. When patients adhere to treatment plans they understand, there are high chances of reduction in the number of visits in the medical emergency rooms and hospitalization thereby lowering the overall costs for medication.

Quality Measures

            Much attention has been put towards formulating quality measures from the external perspective that focusses on the cost effectiveness and patient outcome form society and population (Joel, 2018). The Institute Of Medicine has formulated a myriad of objectives to kick start the measurement process that entail collecting and analyzing data to inform quality improvement initiatives, evaluating facilities and the performance of an individual with regards to the well laid out standards. Other aims include comparing physicians to inform consumer and purchaser choice of providers, notify all the stakeholders regarding the choices and decisions, pointing out, rewarding and sharing the most appropriate practices, tracking and reporting quality over time and dealing with the healthcare needs of every member of the society.

            Quality measures assist the healthcare sector to synthesize and determine patient perceptions, patient outcomes and health care processes to foster patient safety, patient oriented care, organizational structure and positive outcomes. Joel (2018) maintained that quality measures have been implemented to enhance the quality of healthcare and foster for regular improvement. Each of the quality measures pays attention to various healthcare issues but they concentrate on the quality of care being delivered ((Joel, 2018).

            Using performance evaluations of a given hospital and organization can assist healthcare providers to do comparison with the established standards. In the past, nurses majorly focused on quality and positive outcomes of their patients. However, the growing costs and access to quality healthcare has gained much attention in the recent past where societies have expressed their dissatisfaction with the quality of care they currently receive (Joel, 2018, Chapter 24). State and federal agencies together with agencies such as the National Quality Forum among others are agitating for measured performance and for said information to be disseminated to stakeholders ((Joel, 2018).

            Nurse practitioners have a continuing duty of showing how their role in the healthcare has positive outcomes for the patients they interact with on a daily basis. Clinical quality measures or quality measures are critical tools that assist evaluate healthcare outcomes and processes (Joel, 2018). According to the findings of a study by Holley (2016), quality measures offer essential information on how the care offered by nurse practitioners can enhance the care received, as well as, the safety that such care accords. Teaching patients on the need to adhere to medication is one of the effective ways of offering quality of care. Adhering to medication enhances positive outcomes, minimizes urgent care or emergency room visits due to the adverse reactions thereby lowering healthcare costs (Holley, 2016).

             A survey conducted in the year 2014 revealed that there were more than 205, 000 nurse practitioners in the US and that 48% of these professionals were accorded privileges. According to the survey, the privileges and credentialing in hospitals were controlled by the Joint Commission (Holley, 2016).  From the year 2008, the Joint Commission formulated two techniques for assessing competencies for every healthcare professional, the Focus Professional Performance Evaluation and Ongoing Professional Performance Evaluation that determine the experiences of physicians as opposed to the experiences of advanced practice registered nurse (Joel, 2018). This presents a great challenge to advanced practice registered nurse because the experiences are not specific to what nursing  can offer to the quality measure, not because evaluation process correctly measure the contributions of APRNs in addressing the ongoing challenge with quality healthcare access and lowering the costs of healthcare. As such, the advanced practice registered nurse has the duty to formulate measures to assess the performance, quality and point indicators that are specific to their practices. Role development is a major process that in most times are considered new skills and roles are obtained. As a new nurse practitioner, role development can be very difficult since the new nurse practitioner finds herself or himself in a novice role and she or he must carry on with working the process of understanding the new role until she or he becomes competent or proficient.

            The role of nurse practitioners in adopting quality measures is critical to the patient population but also to the stakeholders as well. Therefore, nurse practitioners must be transparent to the type of care they offer. Precisely, practicing without adopting or upholding quality measures could potentially influence whether the nurse practitioner can understand the health plans or receive compensations from healthcare insurance or Medicare.

            In conclusion, using quality measures in the US and across the world is something that has existed for sometimes now. However, the continued use of quality measures can potentially lower the healthcare costs, provide patients with a vibrant choice of the healthcare providers they want to relate with based on the findings of the quality measure that will consequently enhance positive health outcomes for patients. The role of nurse practitioners in adopting quality measures into practice is likely to increase patients’ satisfaction rates, enhance access to quality care and healthcare outcomes of patients.