Roles of Healthcare Professionals Essay

The American healthcare system is shifting to the value-based care model to replace the volume-based care model. The value-based care system rewards healthcare providers basing on the quality of patient care and not on the quantity of the provided care services (Ansmann et al., 2018). Therefore, the value-based care model focuses on the value of care of care and therefore provided are reimbursed and compensated depending on the care outcomes. This aims to facilitate better healthcare, encourage evidence-based practice, reduce the prevalence and the effects of chronic diseases, and promote healthy lifestyle modifications for the patients (Zipfel et al., 2019). Examples of value-based care delivery models include Patient-Centered Medical Home (PCMH), Bundled Payments, and Accountable Care Organization (ACO). This essay aims to provide an analysis of the importance of the value-based care system for the American healthcare system and its impact on the practice of different healthcare professionals like nurses and physicians.

The Impact of the Value-Based Model on the Healthcare System in the U.S

The value-based care model is likely to impact the American healthcare system in many ways. First, the healthcare delivery model is cost-effective and hence patients spend less money to access high-quality care (Ansmann et al., 2018). An example is for patients with chronic conditions like hypertension, cardiovascular conditions, cancer, and diabetes. Patients with such chronic conditions spend a lot of money to obtain good quality care. In such a case, the value-based care model is proactive and hence emphasizes preventative care to prevent chronic conditions (Colldén & Hellström, 2018). Therefore, with such patients, they could be educated to adopt positive lifestyles such as healthy diet, exercises, smoking cessation, reduction of alcohol intake, and adherence to the treatment regimen to effectively manage the chronic conditions or prevent their onset for others. This significantly reduces the number of doctor’s visits, prescriptions, hospitalizations, and medical tests and hence saves money for the patients and the healthcare system as well.

The second benefit is that the value-based care model leads to better health for populations as it focuses on preventative care and the management of chronic conditions. Preventative care strategies such as health promotion and screening of chronic conditions have been shown to significantly reduce healthcare costs (Zipfel et al., 2019). Therefore, the value-based model is likely to reduce healthcare costs for the American healthcare system.

Moreover, the value-based care system reduces the risks and controls healthcare costs, and hence it is also beneficial to payers. This is because the model leads to a healthy population, leading to fewer hospital visits and hence fewer claims. Accordingly, payers will have lesser claims on their investment and premium pools (Cattel & Eijkenaar, 2020). Additionally, since the value-based care model focuses on the quality of care, patients are likely to spend more time with the providers and have their health needs identified and addressed. This leads to improved care services, improved patient satisfaction, and better care outcomes.

The Impact of Value-based Care Model on Nurses

Nursing practice will be impacted by the value-based care model in various ways. For instance, since the aging population with chronic conditions is expected to keep on rising and the care delivery model focuses on preventative care, nurses are expected to play an active role in health promotion and preventative care to prevent chronic diseases, and at the same time, manage the chronic conditions proactively to reduce hospital visits (Cattel & Eijkenaar, 2020).

More importantly, it will be necessary for the nurses to acquire more skills and knowledge to effectively improve the value of healthcare services. For example, to manage chronic health conditions, nurses may be required to use technologies such as telehealth to monitor patients and provide care remotely. Another example is where nurses will need to use the latest and best-available evidence during care provision to ensure the quality of care. nurses will also be required to embrace coordinated approaches to the provision of care such as effective collaboration with multidisciplinary team members to ensure care coordination and high-quality care (Hirpa et al., 2020).

Moreover, the value-based care model aims to promote health promotion and patient education. Therefore, nurses will be required to be proactive in health promotion and improve their knowledge to effectively provide patients with the appropriate health information and help patients make positive and healthy lifestyle modifications (Counte et al., 2019). Nurses will also be required to teach patients on self-management techniques of chronic conditions such as reading and monitoring blood sugar levels for patients with diabetes. Generally, nurses will be required to provide patient-tailored care.

The Impact of Value-based Care Model on Physicians

The value-based care model has reduced the pressure and burnout among physicians. This is because, with value-based care, physicians are only providing care to a few hundred patients. Physicians do close follow-ups for their patients and spend more time together, which gives them adequate time to develop a physician-patient relationship (Colldén & Hellström, 2018). Physicians will also be required to collaborate with other members of the interprofessional team to deliver coordinated care

The value-based care model has made it necessary for physicians to acquire more skills and knowledge in order to effectively improve the value of healthcare services (Hirpa et al., 2020). Therefore, even physicians will need to improve their skills just like nurses in order to be able to deliver high-quality care. Some of these skills include the use of technologies such as electronic health records (EHR) and telehealth. For example, physicians will have to rely on the sharing of access to (EHR) information among all team members.

Physicians will also be required to incorporate patient-centered software systems into their EHRs to assist in searching and capturing all the relevant patient conditions for every patient in order to provide patient-tailored care (Counte et al., 2019). Moreover, since value-based care focuses on preventative care, physicians will have to reduce the unnecessary tests and imaging.

Conclusion

The adoption of the value-based care system has changed healthcare and the way nurses, physicians, and healthcare organizations provide people with care. This care-delivery model focuses on the quality of care and therefore it is team-oriented and focuses on preventative care. The model will affect both nurses and physicians in different ways such as requiring them to adopt a team-approach towards care provision, use the latest technologies to provide care and provide personalized care.

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References

Ansmann, L., Hillen, H. A., Kuntz, L., Stock, S., Vennedey, V., Hower, K. I., & Cologne Research and Development Network (CoRe-Net) (2018). Characteristics of value-based health and social care from organizations’ perspectives (OrgValue): a mixed-methods study protocol. BMJ Open, 8(4), e022635. https://doi.org/10.1136/bmjopen-2018-022635

Cattel, D., & Eijkenaar, F. (2020). Value-based provider payment initiatives combining global payments with explicit quality incentives: a systematic review. Medical Care Research and Review, 77(6), 511-537.

Counte, M. A., Howard, S. W., Chang, L., & Aaronson, W. (2019). Global Advances in Value-Based Payment and Their Implications for Global Health Management Education, Development, and Practice. Frontiers in public health, 6, 379. https://doi.org/10.3389/fpubh.2018.00379

Colldén, C., & Hellström, A. (2018). Value-based healthcare translated: a complementary view of implementation. BMC health services research, 18(1), 1-11.

Hirpa, M., Woreta, T., Addis, H., & Kebede, S. (2020). What matters to patients? A timely question for value-based care. PloS one, 15(7), e0227845.

Putera I. (2017). Redefining Health: Implication for Value-Based Healthcare Reform. Cureus, 9(3), e1067. https://doi.org/10.7759/cureus.1067

Zipfel, N., van der Nat, P. B., Rensing, B. J., Daeter, E. J., Westert, G. P., & Groenewoud, A. S. (2019). The implementation of the change model adds value to value-based healthcare: a qualitative study. BMC health services research, 19(1), 1-12.

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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?

Please include intro and conclusion.

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