Upon its enactment in 2010, Affordable Care Act (ACA) has brought radical changes in the scope of practice of Nurse Practitioners (NPs). The changes that have come with this act are associated with an increase in demand for primary care services. As more people become insured under the new act's provisions, demand for primary care brought by this improved convenience is putting pressure on the healthcare system. Eventually, there are certain health care reforms that are deemed necessary to meet the needs of a population of diversity and different care needs.
The first reform that is seen as a necessity in this era of Affordable Care Act is the need to expand Nurse Practitioners' scope of practice. Affordable Care Act provides that everyone should have a care plan with an insurer of their choice (Kff.org, 2013; Medicare.gov, n.d). This has resulted in a large number of insured individuals who can get access to primary care in order to meet their health care needs as the population becomes keen on health awareness. This improved access to primary care is not, however, limited to those who can secure a healthcare plan. For those who are unable to afford a healthcare plan, ACA is providing a blanket in the form of basic free care. This further increases the pressure on the available workforce of physicians. But even more complications and pressure arise especially now that the act requires that the underserved populations be considered too. Autonomy of NPs and their independent prescribing is needed now than ever before in order to meet these rising needs for primary care services.
However, extending NPs scope of practice brings yet other important consideration of the level of professionalism. More specifically, NPs must be competent in their new areas of practice. Patient Protection of the PPACA is particularly keen on the quality of care and as such, there are legal and ethical issues associated with the expanded scope of practice that nurses must be professionally competent to address. With the autonomous practice, the future of nursing is based on the ability of the practitioners to make patient safety a priority and this requires their professional expertise, experience and ability to meet cultural diversity issues.
Moreover, Affordable Care Act is also opening avenues for what many nurse autonomy advocates have been keen on - the enterprise practice by independent nurses. Recent research by Robert Wood Johnson Foundation (RWJF) suggests policy change that will ensure that NPs and other APRNs are given the leeway to practice to the full extent of their knowledge and training (RWJF, 2015). Carthon observes that, while nurses are recognized as potential leaders in two primary practice models, that is, Independence at Home Demonstration and Patient-Centered Medical Homes, states remain adamant to this vital change that will see nurses deliver quality primary care to all patients. This is so because the federal government has not taken the action to see that states allow autonomous practice and independent prescribing, however, should these changes be implemented, NPs and APRNs are likely to go into private practice to open up more avenues for quality care to a wide population.
In summary, Affordable Care Act has put pressure on the need for primary care by the larger population of diverse demographies. In these changes also come opportunities for nurses especially Advanced Practice Registered Nurses to expand their scope of practice to ensure quality care and patient safety provisions are pursued to their logical conclusions.
ReferencesStudy Explores Impact of ACA on Nurse Practitioners. (2015). RWJF. Retrieved 28 September 2016, from http://www.rwjf.org/en/library/articles-and-news/2015/07/new-study-explores-impact-of-ACA-on-nurse-practitioners.html
Summary of the Affordable Care Act. (2013). Kff.org. Retrieved 28 September 2016, from http://kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/
The Affordable Care Act & Medicare | Medicare.gov. (n.d). Medicare.gov. Retrieved 28 September 2016, from https://www.medicare.gov/about-us/affordable-care-act/affordable-care-act.html
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