The Affordable Care Act: Primary Care and the DNP
The Affordable Care Act: Primary Care and the DNP
The implementation of the ACA not only provides an opportunity for DNP APRNs to demonstrate their expertise in direct patient care, but also creates new avenues for community leadership and programmatic design. ACA nurses are prepared both to help communities understand the ACA legislation and to design new community health initiatives as described below.
The ACA benefits will not be fully utilized by patients without the strong presence of both providers and health educators in the community. Because the ACA is a complex law, the majority of Americans have little understanding of its components or potential impact on their lives. Unfortunately, many persons who could benefit from the provisions of the ACA are at risk for missing this opportunity to gain coverage. A recent survey by the Kaiser Family Foundation found that 47% of the uninsured do not think the new healthcare reform legislation will affect them (Altman, 2011). DNP nurses are prepared to design the outreach programs needed to educate the community about the legislation and how to benefit from its provisions. For example, APRN nurses providing care to uninsured patients can help these patients understand their options for obtaining coverage, educate Medicare beneficiaries about their access to preventive healthcare services without cost-sharing, and encourage all patients to ask their primary care providers about obtaining these services.
The ACA (2010) also authorizes grants for community-based, prevention programs (Community Transformation Grants), work-based wellness programs, and school-based health centers. DNP nurses have the advanced education necessary to design, implement, and evaluate such programs. They can combine their high level clinical expertise and increased leadership competencies to create new, community health initiatives. For example, the nursing-focused Transitional Care Model, created by Naylor, is already being utilized in the implementation of the ACA (Cleary & Wilmoth, 2011). Naylor's model encompasses comprehensive hospital planning and home follow up for older adults. Additionally, Walker's (2012) Skin Protection for Kids program, designed to educate parents and teachers about sun damage- and sun-protection strategies, has also brought health promotion activities out of the clinical setting and into the community. New ACA funding for work-based wellness programs and school-based health centers provides nursing entrepreneurs new opportunities for clinical practice.
Creation of community outreach and care prevention programs will rely heavily on interdisciplinary collaboration to improve quality of care, decrease healthcare costs, and enhance positive healthcare outcomes (Chism, 2010). The ACA actively encourages interdisciplinary collaboration within the medical home delivery model and the new Community-Based Collaborative Care Network Program. Doctorally prepared nurses are particularly equipped to lead and contribute to interdisciplinary teams practicing in medical homes (AACN, 2006 Garnica, 2009). It is essential to recognize and utilize the strengths of various healthcare disciplines and promote collaboration and compromise when needed. Successful interdisciplinary collaboration, along with the creation of adequate policy to support change, will ensure the best use of resources to provide direct patient care and program development to meet the need for healthcare services and system delivery model revision.
Leadership in Community-Based Programs
The implementation of the ACA not only provides an opportunity for DNP APRNs to demonstrate their expertise in direct patient care, but also creates new avenues for community leadership and programmatic design. ACA nurses are prepared both to help communities understand the ACA legislation and to design new community health initiatives as described below.
The ACA benefits will not be fully utilized by patients without the strong presence of both providers and health educators in the community. Because the ACA is a complex law, the majority of Americans have little understanding of its components or potential impact on their lives. Unfortunately, many persons who could benefit from the provisions of the ACA are at risk for missing this opportunity to gain coverage. A recent survey by the Kaiser Family Foundation found that 47% of the uninsured do not think the new healthcare reform legislation will affect them (Altman, 2011). DNP nurses are prepared to design the outreach programs needed to educate the community about the legislation and how to benefit from its provisions. For example, APRN nurses providing care to uninsured patients can help these patients understand their options for obtaining coverage, educate Medicare beneficiaries about their access to preventive healthcare services without cost-sharing, and encourage all patients to ask their primary care providers about obtaining these services.
The ACA (2010) also authorizes grants for community-based, prevention programs (Community Transformation Grants), work-based wellness programs, and school-based health centers. DNP nurses have the advanced education necessary to design, implement, and evaluate such programs. They can combine their high level clinical expertise and increased leadership competencies to create new, community health initiatives. For example, the nursing-focused Transitional Care Model, created by Naylor, is already being utilized in the implementation of the ACA (Cleary & Wilmoth, 2011). Naylor's model encompasses comprehensive hospital planning and home follow up for older adults. Additionally, Walker's (2012) Skin Protection for Kids program, designed to educate parents and teachers about sun damage- and sun-protection strategies, has also brought health promotion activities out of the clinical setting and into the community. New ACA funding for work-based wellness programs and school-based health centers provides nursing entrepreneurs new opportunities for clinical practice.
Creation of community outreach and care prevention programs will rely heavily on interdisciplinary collaboration to improve quality of care, decrease healthcare costs, and enhance positive healthcare outcomes (Chism, 2010). The ACA actively encourages interdisciplinary collaboration within the medical home delivery model and the new Community-Based Collaborative Care Network Program. Doctorally prepared nurses are particularly equipped to lead and contribute to interdisciplinary teams practicing in medical homes (AACN, 2006 Garnica, 2009). It is essential to recognize and utilize the strengths of various healthcare disciplines and promote collaboration and compromise when needed. Successful interdisciplinary collaboration, along with the creation of adequate policy to support change, will ensure the best use of resources to provide direct patient care and program development to meet the need for healthcare services and system delivery model revision.
