Evolution of the health care system

The Evolution of the Health-Care System

The evolution of the health-care system includes radical steps that place a new emphasis on service delivery value, care quality, and population health. With these changes come new opportunities and challenges for the nursing profession in the United States. More nursing employment will be created in the community, but acute hospital care will be reduced. With the greater number of registered nurses employed in the United States than physicians, nurses are positioned to play a critical role in the shift. The success of the modifications is heavily dependent on how well equipped or familiar the nurses are with the new system. This procedure also results in the metamorphosis of nurses. Meanwhile the questions raised about the number of registered nurses (RNs) have calmed, it is important to shift resources and attention from increasing the number of registered nurses to reorganizing the system to aid nursing practice. For effectiveness of this transformational process, we must redress the changing responsibilities and roles of nurses and examine the regulations, policies and new educational requirements arising (Bankston & Glazer, 2013). New competency areas, specialties, right placement of nursing personnel, as well as the right combination of nurses in various locations is crucial in obtaining the full benefits of the new alignment.

Expected Changes in the Redesigned Healthcare System

Shift in Mode of Payment

Mode of payment is changing from fee-for-service payment (which stresses on the quantity of service rather than quality) towards a value-based method of payment. Charging of clients based on the amount of service given by the care givers phased out and replaced with a value-based mode of payment which hinges on the quality of services instead (Bouchaud et al., 2016).

Use of Electronic Health Record

Progressively, nurses are utilizing information from EHRs (electronic health records) and registers of patients to identify abandoned health requirements and to develop practical population health measures. Adoption of health data technology enables medicinal practitioners to get to patient and group data quickly and additionally bolsters productive communication between care providers. At the point when outlined well, these frameworks enhance coordination, improved nature of care, and lower costs (Cooper, Frank & Shogren, 2014). Telehealth frameworks permit medicinal care givers to remotely screen and speak with patients, taking into consideration opportune recognizable proof of emerging developments that benefit the patients. Compelling utilization of health information and telehealth frameworks are fundamental for fruitful care coordination.

Medical Homes

More and more Patient-Centered Medical Homes (PCMHs) continue to develop to provide a comprehensive medical care, accessible to the society. The adoption of the model, Patient-Centered Medical Homes (PCMHs) envisages growth and wide acceptability by the public. Accountable Care Organizations (ACOs) with this change, adoption of Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMH) health care models occur. Consequently, the health care providers have redirected the focus towards preventive treatment and outpatient services (Cooper, Frank & Shogren, 2014).

Continuum (Continuity Concept)

Attachment of value to the health management system emerges the need for follow up of patients to monitor their progress and attend to their unique health needs.

Nurse-managed Health Clinics

Increased demand for care givers and the inherent shortage of employed registered nurses is anticipated to create the need to develop nurse-managed health clinics.

Public Health

Another transformation in the new health practice is the population health. Lately, the term "population health" is common in the US medical fraternity. The expression is used in the US medical environment to refer to the provision of accountable longitudinal care as well as accountability for the results of a distinct group of patients whose medical services requirements need attention across several considerations (for example, hospice, home, pro-acute settings, hospitals, primary care).

The recognition of community as the originators of most diseases has led to the adoption of a community-based approach to nursing. The role critical role played by public health nurses in the development, implementation, and monitoring programs, through disease prevention and health promotion mechanisms, has improved the health of populations (Cooper, Frank & Shogren, 2014). Today, there is developing acknowledgment that many single medical problems in the community originate from within the setting. Thus, to reduce the challenges, enhanced community health programs are essential. In their practice, nurses and other health care practitioners must understand the social, political, and financial elements that affect the health of the population and each patient's health.

More up to date models of therapeutic services conveyance, for example, Accountable Care Organizations(ACOs) or Patient-Centered Medical Houses (PCMHs), have motivating force systems that ties "value" to indicators of health in these patient groups (Peckham, 2016). The group's identification takes place through assessment of the individual care needs as well as other factors, for example, social and financial status.

New Roles of Nurses

The roles of nurses will grow to include the provision of health care to people in their homes. The nurses will perform a task of linking the hospital services to the community or patients. Elaborate roles of nurses, as a result, calls for more training to impart them with new skills to match the competence required by these new functions (Fraher, Spetz & Naylor, 2015). However, the existing educational system exhibits varied capacities to sufficiently prepare the nurses for the ever-dynamic health care system. A more robust inclining program that will address population health and provide nurses with requisite skills and abilities to handle chronic conditions must be adopted.

Proper coordination and management of functions will require nurses to establish the effect of community on an individual patient's results. This requests more prominent learning of the study of disease transmission, human science, and social determinants of health. Nurses will progressively utilize health data technologies to improve evidence-based practice. The information contained in the Electronic Health Records (EHRs) can be used to evaluate the viability of interventions for given patients quickly, and also to survey more extensive connections between mind procedures and patient results (Fraher, Spetz & Naylor, 2015). Medical attendants can use these frameworks both to improve immediate care needs and to direct facility approaches toward improved care delivery.


The United States therapeutic services framework is experiencing transformational changes. Nurses are the only professionals in the health care sector operating in every setting such as clinics, treatment and diagnostic facilities, ambulatory care, home health, long-term care and hospitals. The roles of nurses in these setting vary in every aspect, and they are expected to effectively and efficiently play such roles with the aim of improving health and better value (Michel, Waelli, Allen & Minvielle, 2017). Moreover, it is of importance for the NCLEX to examine the new functions, together with the transition of nurses from the emergency department and the broadening of the duties and functions of nurses in population health, long-term care, informatics, and care management and coordination.

The new assignments will prompt nurses to be proficient in establishing the effect of the characteristics of the community on the general population and patients. The results enhance the understanding of the complex care requirements of aged patients, develop and execute care coordination plans. Also, it improves the use of information and innovation to improve patient care and work together successfully with various groups of experts in the health sector.

Further, training programs for nurses should include the skills required for successful execution of the duties right from the entry-level and proceeding training programs. Instructors need to give careful consideration to planning programs that empower medical caretakers to increase new abilities and capabilities consistently; getting ready workforce and preceptors to educate in the community and ambulatory settings; and utilizing new instructive modes, for example, online training and flipped classrooms.

Finally, law makers need to employ current directions to enable medical caretakers to work at the most elevated level of their learning to optimize the gain from their skills. The effectiveness of these major transformations requires timely mobilization of all the players in the medical sector (employers, policymakers and nurse leaders) to develop the capacity of nursing in a transformed health care system.


Bankston, K., & Glazer, G. (2013). Legislative: interprofessional collaboration: what’s taking so long?. OJIN: The Online Journal of Issues in Nursing, 19(1).

Bouchaud, M., Swan, B. A., Gerolamo, A., Black, K., Alexander, K., Bellot, J., ... & Scherzer, R. (2016). Accelerating design and transforming baccalaureate nursing education to foster a culture of health.

Cooper, R., Frank, G., & Shogren, C. (2014). The Impact of Health Care Reform Initiatives on Ethical Conflict and Opportunities for Nurses to Improve Quality of Care While Enhancing Their Work Environments. Open Journal of Nursing, 4(09), 644.

Fraher, E., Spetz, J., & Naylor, M. D. (2015). Nursing in a transformed health care system: New roles, new rules.

Michel, L., Waelli, M., Allen, D., & Minvielle, E. (2017). The content and meaning of administrative work: a qualitative study of nursing practices. Journal of Advanced Nursing.

Peckham, S. (2016). Decentralisation–A Portmanteau Concept That Promises Much but Fails to Deliver? Comment on" Decentralisation of Health Services in Fiji: A Decision Space Analysis". International journal of health policy and management, 5(12), 729.

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