Roles of Healthcare Professionals Paper

Roles of Healthcare Professionals Paper

Roles of Healthcare Professionals Paper

Value-based care has grown exponentially over the past few years. It is a healthcare system whereby the healthcare providers are rewarded with incentive payment in return for the quality of care they provide to patients. In other words, the value-based care framework has shifted the overarching goal of the value for patients to the value of health, seen as health outcomes per unit cost. This paper discusses why a value-based system may improve healthcare in the U.S. while focusing on how current policy has transformed the current practice of nurses, physicians, and other healthcare professionals, the distinction between nurses, physicians, and healthcare professionals working in a fee-for-service system and a value-based system, and my view on shared power between nurses and physicians in the healthcare system, and its impact on care.

Value-Based System in Improving Healthcare in the U.S.

            Different scholars have defined value-based care differently. Teisberg et al. (2020) define value-based care as a system whereby the value in healthcare is the measured improvement in a person’s health outcomes for the cost of achieving that improvement. In value-based care, a healthcare team measures the health outcomes and costs of its care for each patient, then uses the information to facilitate constant improvement in care. According to Teiaberg et al. (2020), value-based care aims to transform the healthcare system to provide more value for patients. In this case, value in healthcare is equal to desirable patient outcomes. A value-based system may improve healthcare in the U.S. for several reasons.

            The value-based system may improve healthcare in the U.S. by connecting care professionals to their purpose, promoting professionalism, and motivating them in their work, thus making them more likely to improve care and patient outcomes. As mentioned earlier, the system coins value as improving patient outcomes relative to the cost of driving the improvement. Therefore, the system aligns healthcare providers with their patients, while the patient outcomes show the care providers’ ability to do their work. The system can therefore motivate healthcare professionals, thus improving their work and overall care outcomes.

            The system can also improve healthcare in the U.S. by decreasing the need for ongoing care. When patients’ health outcomes are met through the system, they may be saved from complications and disease progression, which would require ongoing care. Thus, the system will help patients deal with current conditions and save them from healthcare costs related to ongoing care needs. It is worth noting that as the patient’s need for ongoing care is reduced, the healthcare costs and expenses to the system are also reduced. Hence, the system could also reduce the per capita cost, translating to lesser care costs and reduced risk of unnecessary care spending. In addition, reduced care costs will enable more people to access and afford care services, leading to a healthier society.  

             Furthermore, the value-based care system may improve healthcare in the U.S. since it gives healthcare workers more accountability for improving patient outcomes while providing them the flexibility to provide the right care when needed and on their own time. Abicalaffe and Schafer (2019) note that the flexibility and accountability allowed for healthcare workers in value-based care motivate them to provide better services, leading to more patient satisfaction, better care provision, and overall desirable care outcomes. When patients are satisfied with the care experience they receive, the care providers doing their best, and outcome measurements being patient outcomes, the health of individuals, populations, and society consequently improves. Therefore, overall health care in the U.S. would improve by adopting value-based care. 

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The Role of Current Policy in Transforming the Current Practice of Care Professionals

The current policy has considerably transformed the practice of nurses, physicians, and other care professionals. One policy that has changed the practice of healthcare professionals is the Affordable Care Act (ACA). Since the ACA focuses on producing better outcomes, it has pushed nurses to demonstrate that they can provide better, more effective care. Ercia (2021) notes that the Affordable Care Act increased the demand for nurses, especially nurse practitioners, to pursue advanced education to practice according to the policy’s standards. Advanced education means an upgrade in nursing roles. For instance, an advanced practice nurse is allowed to practice autonomously in some states and perform roles such as prescription, certifying death, and anesthesia, among others. Therefore, the policy has brought additional roles for nurses in practice.

Furthermore, current policy in some states has brought about nurses’ autonomy in practice. For instance, in some states, nurses, especially advanced practice nurses, are allowed to practice individually without being under the direct supervision of a physician. These nurses are therefore enabled to exercise their full scope of practice. Some may even venture into independent practice, opening their clinics, thus helping bridge the healthcare access gap. Autonomy in practice also increases the nurses’ confidence and motivates them to provide even better patient care.

Physician’s practice has also not been left behind. The policy has transformed physicians’ practice by enabling them to work with other care professionals, mostly nurses. Policies that led to autonomy in nursing pushed the doctors to respect other care professionals and work with them as a team, thus ensuring that they produce better outcomes. Even though physicians are positioned to lead and contribute n transformative changes in the healthcare system, they now work as a team, engaging other healthcare professionals in every step of care to ensure that patients get holistic and patient-centered care.

Additionally, the practice of other healthcare providers, such as pharmacists, has been transformed to keep up with the transformed practice of nurses and physicians. For instance, since the new value-based care system focuses on care quality and outcomes, other healthcare professionals must also improve their work to ensure desirable care quality. Additionally, value-based care measures success in terms of the patient’s care outcomes, thus requiring the practice of all healthcare professionals to improve, thus promote better care outcomes. These care professionals have also emphasized working with the nurses and the doctors to promote desirable quality of care, improved patient outcomes, and reduced care costs (Ercia, 2021).

Distinction Between Care Providers Working in a Fee-For-Service Care System and a Value-Based Care System

A clear distinction exists between nurses, doctors, and other healthcare professionals working in fee-for-service and value-based care systems. According to Martin et al. (2020), the fee-for-service system is a healthcare system whereby healthcare providers are paid for each service they provide. In this payment model, healthcare services are unbundled, meaning each care service is paid for separately. In addition, the system gives more incentives to care providers as they provide more care services. Thus, it is worth noting that in the fee-for-service care system, payment depends on the quantity of care rather than its quality.

The greatest distinction between healthcare workers providing care in the two systems is the measurement that leads to payment or reimbursement. As mentioned earlier, healthcare professionals working in a value-based care system have their payment measured based on the care outcomes of the patients. In contrast, the fee-for-service quantity of care services provided translates to the amount of payment. Therefore, care providers in the value-based care system may focus more on care quality than care providers in the fee-for-service system, thus providing better care and leading to better outcomes.

Additionally, since the care quantity determines payment, healthcare professionals in the fee-for-service system may focus on providing services to as many patients as possible, thus missing out on providing the right quality of care. Research shows that healthcare professionals in a fee-for-service system are more likely to provide poorer care than care providers in value-based care due to the differences in care focus (Cohen et al., 2022). Therefore, care providers in the fee-for-service may overlook care quality, thus not providing patients with the care they need, despite caring for many people. Conversely, care providers’ focus in the value-based care system is the patient outcomes, which shows quality care.

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Furthermore, care providers in the fee-for-service system can provide care to patients, provided they can afford to pay for the service. Tummalapalli et al. (2022) note that healthcare consumers in the fee-for-service system do not necessarily need to have care provider networks. They are free to see and get services from any care provider they want. On the other hand, care providers in the value-based care system provide care to all patients while emphasizing patient outcomes overpayment.

Shared Power Between Physicians and Nurses and Its Impact on Care

Shared power between doctors and nurses in my healthcare system is valued. I believe shared power between these professionals is vital since it promotes collaboration, care coordination, teamwork, and moving together toward achieving healthcare goals. It also helps the professionals avoid seeing each other as competitors, thus promoting respect, which facilitates working together for better care outcomes. Therefore, I believe physicians and nurses should continue enjoying shared power.

Equal and shared power between physicians and nurses significantly impacts care. According to Aghamohammadi et al. (2019), shared power between nurses and doctors enables collaboration, which promotes better care. Care collaboration and coordination are impossible when nurses and doctors, the major care professionals in the team, cannot agree and see each other as competitors. Therefore, it is essential to have shared care to enhance care coordination and collaboration.

Additionally, shared power between nurses and doctors prevents delays in care, enabling each to exercise their full potential, thus improving individual patients’ and overall care outcomes. Tasks delegation enables the care providers to reduce the workforce, thus reducing care service delays. For example, an advanced practice nurse can handle prescriptions as a physician handles assessments and diagnoses, thus easing the workforce, reducing delays, and thus improving care.

Conclusion

Value-based healthcare systems would considerably improve care in the U.S. due to improved care quality related to the system. The current policy has transformed nurses, physicians, and other care providers’ practice through the Affordable care act and the value-based system. As discussed above, there is a clear distinction between care providers working in the fee-for-service system and value-based care. Shared power between physicians and nurses should be encouraged due to its positive impact on care.

 References

Abicalaffe, C., & Schafer, J. (2020). Opportunities and Challenges of Value-Based Health Care: How Brazil Can Learn from U.S. Experience. Journal of Managed Care & Specialty Pharmacy, 26(9), 1172–1175. https://doi.org/10.18553/jmcp.2020.26.9.1172

Aghamohammadi, D., Dadkhah, B., & Aghamohammadi, M. (2019). Nurse-Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 23(4), 178–181. https://doi.org/10.5005/jp-journals-10071-23149

Cohen, K., Ameli, O., Chaisson, C. E., Catlett, K., Chiang, J., Kwong, A., Kamrudin, S., & Vabson, B. (2022). Comparison of Care Quality Metrics in 2-Sided Risk Medicare Advantage vs Fee-for-Service Medicare Programs. JAMA Network Open, 5(12), e2246064. https://doi.org/10.1001/jamanetworkopen.2022.46064

Ercia A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California, and Texas. BMC Health Services Research, 21(1), 920. https://doi.org/10.1186/s12913-021-06961-9

Martin, A., Kirby, H., Ayers, G., Kelly, A., Riley, A., & Boucher, S. (2020). Demonstration of payer readiness for value‐based care in a fee‐for‐service environment: Measuring provider performance on sealant delivery. Journal of Public Health Dentistry, 80, S50-S57. https://doi.org/10.1111/jphd.12414

Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and Implementing Value-Based Health Care: A Strategic Framework. Academic medicine: Journal of the Association of American Medical Colleges, 95(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122

Tummalapalli, S. L., Estrella, M. M., Jannat-Khah, D. P., Keyhani, S., & Ibrahim, S. (2022). Capitated versus fee-for-service reimbursement and quality of care for chronic disease: a U.S. cross-sectional analysis. BMC Health Services Research, 22(1), 19. https://doi.org/10.1186/s12913-021-07313-3

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Assignment Description:

Roles of Healthcare Professionals

This assignment will be at least 1500 words or more. Reflect on the roles of nurses, and other healthcare professionals as the roles of physicians in the healthcare system moves from one of working in silos to a more progressive value-based system. Write a paper that discusses in detail why a value-based system may improve health care in the U. S. and address the following questions:

How has current policy transformed the current practice of nurses, physicians, and other healthcare professionals?

What distinction can you make between physicians/healthcare providers working in a fee-for-service system and a value-based care system?

How do you view shared power between physicians and nurses in your healthcare system? How does it impact care?