Quality measures and Pay for Performance Affect Patient Outcomes.

Quality measures and Pay for Performance Affect Patient Outcomes.


Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.Quality measures and Pay for Performance Affect Patient Outcomes.


Include the following:

  1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse\’s role and responsibility.
  2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.Quality measures and Pay for Performance Affect Patient Outcomes.
  3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
  4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.Quality measures and Pay for Performance Affect Patient Outcomes.


You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.Quality measures and Pay for Performance Affect Patient Outcomes.

As time goes by, there will be changes in individuals, the system, and the entire healthcare system. Through changes, the health care system requires updating or restructuring in order to adapt to changes in the environment. The health care system has to restructure or reform for health promotion and disease prevention. The 2010 Affordable Care Act (ACA) is among the legislations aimed at decreasing the uninsurance level in the country and it will enhance positive results for American citizens pursuing medical assistance. The ACA’s Prevention and Public Health Fund, which was designed to offer fiscal stability for public health, offered essential funds for public healthcare services during the Great Recession. However, it was particularly susceptible to concurrent budget reductions (Chait & Sherry GliedRobert F. Wagner Graduate School of Public Service, 2018).Quality measures and Pay for Performance Affect Patient Outcomes.

Several interventions can improve state-level policy analysis and health care system engagement that has already shown to be more effective, and enabling the federal government’s convening authority could be an essential and efficient mechanism for change, particularly if sponsored by any funds. Through the increase of having minimum coverage level and insurance premiums, Americans have been able to receive better healthcare services and pursue assistance. They focus on expanding the capacity of public health by developing legislation that promotes national prevention, health promotion, and councils for public health, drawing together public health resources to enhance the effectiveness of public health. Quality measures and Pay for Performance Affect Patient Outcomes.

Quality measures and pay for performance affect patient outcomes

Pay for Performance in healthcare (P4P), often identified as value-based payment, encompasses payment strategies that connect budgetary incentives/disincentives to provider performance ((Catalyst, 2018). Focusing on value-based payment is part of a national strategic approach. The payments are therefore based on quality and value. Pay for performance will impact the reimbursement of the hospitals as they will not obtain maximum reimbursement as they are of good standards and consistency. Hospitals will get reimbursement depending on the standard of their care and efficiency. CMS has established further compensation for performance models on Healthcare plans that impact Medicare patient reimbursement.Quality measures and Pay for Performance Affect Patient Outcomes. Hospital Readmissions Reduction Program (HRRP), the Hospital-Acquired Condition (HAC) Reduction Program, and The Hospital Value-Based Purchasing Program (VBP) were three programs. In 2010, ACA developed a purchasing program that was based on value. It was designed to enhance thecare  quality and patient encounters to pursue developed best clinical activities and enhance patient satisfaction through the HCAPS. Hospitals will be ranked on the basis of improved performance and accomplishment. Hospital readmissions reduction program was set up by the ACA, which required extra consideration, which has many cases of readmission with illnesses such as replacement of knee or hip, COPD, pneumonia, and heart failure.Quality measures and Pay for Performance Affect Patient Outcomes.

Hospitals with readmissions on the same grounds owing to poor performance should acknowledge a rate cut of up to 3 percent. It is, therefore, the responsibility of nurses to prevent readmission by following hospital policy. For instance, certain hospitals do CUN7 for patients with heart failure and COPD to see a specialist within 7 days of follow-up. Nurses could make appointments for those patients with COPD and to prevent readmissions. Nurse practitioners could schedule appointments to prevent readmissions for those COPD patients. .ACA further created the Hospital-Acquired Condition Reduction Program in 2015, which lowers reimbursement to hospitals by 1 percent on the grounds of conditions acquired in hospitals, like surgical site infection, pressure sores from bed rest patients, and hospital falls and injuries.Quality measures and Pay for Performance Affect Patient Outcomes.

Professional nursing leadership and management roles

Healthcare practitioners ought to consider defined results and principles; as such factors specifically impact nursing, as well as trends associated with education and employment. The 2010 Affordable Care Act (ACA) addressed a drive towards value and quality which is also explicitly related to the compensation and payment of organizations and providers (McNiff, 2018). Professional management and leadership roles in nursing have emerged to deal with new trends and facilitate the quality and safety of care of patients in the healthcare environment. It is essential for leadership to be aware of the changes in order to respond to trends, and have a strategy and plan to search for further progress and outcomes.Quality measures and Pay for Performance Affect Patient Outcomes.

Managers and supervisors should be conscious of the trends and recognize what is needed to support the society. In understanding the needs, they will look for a means of supporting the healthcare environment. The functions of leadership should change with the trends, and also have ways to follow the trends. By following them, it will enhance the quality and safety of care for patients. For instance, in our society, we currently have problems with Corona Virus worldwide and in order to avoid the spread of disease; our facilities require leadership to make choices on the means of mitigating the disease. They ought tobe conscious about the local COVID-19 state of affairs and recognize where to turn for consistent, latest information in the local community. This could facilitate the prevention of the spread of the disease.Quality measures and Pay for Performance Affect Patient Outcomes.

Research emerging trends

Tracking the trends in the healthcare environment is particularly necessary, because time moves too quickly, and the needs of the healthcare system are evolving. Research studies are necessary for following the trends. – Research is often needed to be up-to-date in order to track the trends. Research studies examining the correlation between nursing education and healthcare experience followed, and the findings were consistent with Aiken’s previous assumptions that improved education and training levels lead to enhanced healthcare experience, especially in challenging and technologically sophisticated healthcare settings (Jennifer, 2018).Quality measures and Pay for Performance Affect Patient Outcomes. The trend in healthcare environments today includes direct patient care, which focuses on patient education and counseling. Therefore the healthcare environment not only concentrates on communication with patients, documentation, and medical administration but also provides direct care by educating and counseling patients within five years. Another trend is that the amount of professional nurses and physician assistants is increasingly growing, meaning that more nurses can pursue more education within 5 years to ensure better patient care.Quality measures and Pay for Performance Affect Patient Outcomes.

In conclusion, in society today, our concerns include high costs of medical care and insurance which deters patients from seeking medical care. As time passes by, the United States has established laws that allow more patients to seek professional care, named the 2010 Affordable Care Act (ACA).Quality measures and Pay for Performance Affect Patient Outcomes. It is one of the healthcare legislation to lower the uninsurance level across the nation, to enhance the positive outcome for American people pursuing professional care. More reforms have been made which aim to minimize care costs based on quality and efficiency. The problem facing nurses and leaders includes the society which continues to change. Nurses and leaders need to conduct research to enable them to follow the trends to overcome the issue.Quality measures and Pay for Performance Affect Patient Outcomes.