Health Policy


Robert Wood Johnson Foundation website has highlighted and elaborated diverse issues related to health policies with bid of promoting healthy development for communities nationwide and also globally. The foundation believes that best health policies cause high quality care that can ensure lifelong benefits, especially for the most vulnerable populations, and improve the health of the nation. The organization works to advance professionalism in nursing to improve health for the general population. Therefore, to achieve its goal, it comments influence and supports in various ways the conceived and implemented policies.

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The Patient Protection and Affordable Care Act is a policy that favors nurse staffing and RWJF website have seen the advantage of the policy in improving the healthcare sector with the key item surrounding the policy proposal is based on staffing levels on need and not just numbers. The three patient care Delivery models under Patient Protection and Affordable Care policy have been explored. This paper checks at the Patient Protection and Affordable Care policy and how the policy has changed role of nurse to the care integrators and coordinators from front-line caregiver and aid in giving help to underserved people (Shortell,, 2015).
Today, there is change in the system of Healthcare and it is focusing on curative, prevention and wellness. The health policies aim at development of health models that switches nursing roles to community health care from acute care settings. The 2010 PPACA (Patient Protection and Affordable Care Act) supported formation of nurse-managed health clinics, medical homes and ACOs with creation of new payment approaches. ACA (Affordable Care Act) formation has changed role of nurse to the care integrators and coordinators from front-line caregiver and aid in giving help to underserved people (Corlette S,, 2018). All models are focused on concept of continuity which is integrated system that tracks patient over time.

Medical Home/Health Home
They are same to ACO and are health models generated to focus on giving primary care that is synchronized, managed, patient-centered, ample, and accessible and believe in safety and quality. It is not created for profit purposes but they are meant to attain primary care distinction. With the aid of primary care providers including nurse, doctors and certified nurse-midwives, the model solves health care problem (Jones, 2017). The front-line healthcare being nurses play major role in model since the actively participate in disease prevention, health promotion, interpret and order lab tests while they can refer patient for specialized care.

Nurse-Managed Health Centers (NMHCs)
It was developed by ACA to control of chronic conditions, foster disease prevention, promote the primary care in rural and medically underserved people around United States. The nurse midwives, public health nurses clinical nurse specialists, clinical nurse specialists and nurse practitioners all manage NMHCs. the needy communities benefit from diagnosis, pre- and post- natal care, and prescription to illness and referral to specialists (Clancy, 2017). The model aim is providing medically underserved and vulnerable populations with enhanced easy access to primary care and boost up the nursing leadership and practice for students by serving training sites and keep workforce and patient information.

ACOs (Accountable Care Organizations)
They are group of hospitals, doctors and other health care givers who willingly come jointly to offer harmonized high quality care to their Medicare patients. it is a unit constructed by ACA reforms of 2010 and ensures affordable and quality services are given to patients. They aim to offer high quality services at low costs to the chronically ill patients. ACO are particular group of suppliers and providers allocated by ACA and have physician assistants, physicians, clinical nurse specialists (CNSs) and nurse practitioners (NP) (Corlette S,, 2018). The registered nurses practice nursing leadership in ACO and lead value assurance and generating improvement schemes.
There are positive examination and comments about the feasibility of the models to renovate the health care services delivery around U.S. One of the members Richard Besser welcomes the new health care delivery models and the role of nursing in these care models while the rest of the members also fully support but questions some areas of concern and how rectification should be done. Many nurses have articulated worry concerning the service quality provided by healthcare models and hospitals when the large number of visit the hospital for treatment making it to flood.

There are many elaborating that (ACA) Affordable Care Act will help many people causing crowding in hospital and will absolutely impact the services quality in hospital setting and health systems in taking care of patient influx. Influx will cause increase in costs of administration, more paper work, over-seeing, care and disease management and time in dealing with Medicare of many newly insured patients. Furthermore, influx of patients means that there is need for more healthcare providers and nurses. Hence, there is need for and enough advances to be taken to accomplish health care providers and nurse needs because it will directly affect care quality. Notably, the motivation and status of existing work force will be negatively impacted and therefore, there is extreme gaze ahead for the high-quality of health services given to the patient that is she thought in quality relatively to quantity.

The Patient Protection and Affordable Care Act in Robert Wood Johnson Foundation website has received positive comments from Richard Besser especially on section 1332. The foundation is promising to work alongside the policy because of its positive impacts in health sector (Besser.R, 2018). He is thrilled by the healthcare change as it checks on nurse potential in transforming US health care scheme especially recently-issued guidance for 1332 waivers that gives chances for states to radically modify their individual insurance markets. He is more focused on the significance of new reforms concerning health due to costs, chronic disease increase and preventive over curative care. The NMHCS, medical homes and ACOs are all new healthcare delivery models that enhance preventive services care that leads to easy management of community chronic diseases.

Therefore, it helps in minimizing the related costs and general problem high cost of health service provisions through raising awareness and promoting disease prevention. He states that preventive care requires large number of educated employees with good leadership’s skills for improvement of community’s health care. Furthermore, he adds up nurses have building capacity to strong association and coordination with patients and providers leading in developing and diverse heath care models. According to him, nurses are significant to all patient-centered care delivery models and the new health care delivery model concept gives the facilities to deserving underserved individuals which is worthy.

In a nutshell, Robert Wood Johnson Foundation supports these models which are largely cost effective, patient-centered, accessible and competent. According to their comments, founding of these types of health care delivery replica has altered the nursing role and set new limit for the nurses. Consequently, the chances for the nurses are growing and the demand of the skilled, educated and professional nurses is fundamental throughout this shifting time of health care system (Besser.R, 2018). The nurses are the most important part of health care scheme and their role has altered and progressed with the accomplishment of the health care policies and health care delivery scheme. These types of changes and forms have changed the whole health care scheme of the United States to community from acute care settings and have aided many underserved populace (Clancy, 2017). On the other hand, acquaintance and knowledge of the health change should be given to everybody.


1. Besser.R, (2018, December 14). RWJF; Comments from Richard Besser on Guidance Relating to Section 1332 of the ACA. Retrieved from
articles-and-news/2018/12/comments-from-richard-besser-on-guidance-relating-to-section-1332-of-the-aca.html 2. Clancy, C. (2017). Innovative careers in nursing and health care reform: What nurse leaders need to know. Voice of Nursing Leadership, 10(6), pp4-6
3. Corlette S, (2018, March 19). RWJF; Insurers Remaining in Affordable Care Act Markets Prepare for Continued Uncertainty in 2018, 2019. Retrieved from
4. Jones, R. (2017). Education for nurses in community-based care settings. Voice of Nursing Leadership, 10(6), pp12-14
5. Shortell, S.M, Gillies, R., and Wu, F. (2015). United States innovations in health care delivery. Public Health Reviews, 32: pp190-212

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