There are several movements in healthcare reform in the USA that promote the transition from disease-oriented healthcare to a culture of wellness: the Patient Protection and Affordable Care Act (ACA), the Culture of Health initiative of the Robert Wood Foundation, and the increased focus on person-centered and fundamental care. These three movements respectively drive healthcare reform on the political, community, and nursing practice levels.
The ACA extended health insurance and thus improved access to healthcare for at least an additional 50 million Americans who were previously uninsured (Nardin, Zallman, Sayah, & McCormick, 2016). Sections 4103 and 4104 of the act eliminate cost sharing for annual wellness visits (Myerson, R., & Laiteerapong, 2016). Ultimately, the ACA should reduce the overall burden of chronic diseases by a greater focus on primary healthcare and preventive care.
The Culture of Health is based on the understanding that health is more a product of social, political, and environmental conditions than a product of individual behavior and genetic disposition (Allegrante, 2015). The influence of the Robert Wood Foundation is broad and focuses on funding community health initiatives (Robert Wood Foundation, n.d.). The impact on nursing practice is in the holistic perspective on health care, which supports the trend towards adopting person-centered care.
The third development is an increasing focus on person-centered care and fundamental care (Feo, Conroy, Marshall, Rasmussen, Wiechula, & Kitson, 2016). Person-centered care promotes the importance of the patient and family involvement in healthcare. The shift in emphasis from health provider to patient constitutes a fundamental change in perspective that requires a change in medical education.
The synergistic effect of these three developments in American healthcare should improve patient experience and the overall health status of the nation, and lower the national burden of healthcare costs (Altman, Butler, & Shem, 2016). Nurses will increasing be called upon the bridge the gap between access and coverage and become integrated into teams that coordinate chronic disease management and preventive care. With these changes, nurses will find increased employment opportunities in primary and community healthcare settings (Altman, Butler, & Shem, 2016).
References
Allegrante, J. P. (2015). Policy and environmental approaches in health promotion: What is the state of the evidence? Health Education & Behavior, 42(IS), 5S-7S. doi: 10.1177/1090198115575097.
Altman, S. H., Butler, A. S., & Shem. L. (2016). Assessing Progress on the Institute of Medicine Report: The Future of Nursing. Washington, D. C.: National Academies Press. http://www.ncbi.nlm.nih.gov/books/NBK350166/
Feo, R., Conroy, T., Marshall, R. J., Rasmussen, P., Wiechula, R., Kitson, A. L. (2016). Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses. Nursing Inquiry, 00, 1-11. Doi: 10.1111/nin.12152
Myerson, R. & Laiteerapoing, N. (2016). The Affordable Care Ace and diabetes diagnosis and care: Exploring the potential impacts. Current Diabetes Reports, 16(4). 27. doi: 10.1007/s11892-016-0712-z
Nardin, R., Zallman, L., Sayah, A. & McCormick, D. (2016). Experiences applying for and understanding health insurance under Massachusetts health care reform. International Journal for Equity in Health, 15(110).
Robert Wood Foundation (n.d.). Building a Culture of Health. Retrieved on August 30, 2016 at http://www.rwjf.org/content/dam/COH/RWJ000_COH-Update_CoH_Report_1b.pdf
Svanstrom, R., Andersson, S., Rosen, H., & Berglund, M. (2016). Moving from theory to practice: esperience of implementing a learning supporting model designed to increase patient involvement and autonomy in care. BMC Research Notes, 9, 361. doi: 10.1186/s13104-016-2165-5.
