Patient-Centered Medical Home
The Patient-Centered Medical Home (PCMH) care has been observed as an alternative technique to the inefficient medical model in the United States of America (Sahasranaman, 2016). PCMH is a collaboration between the sick, families, primary health providers, specialists, and social groups with a goal of offering comprehensive care and diminishing the level of disparity in the healthcare system. The method aims at enhancing coordinated care and the creation of a long-term relationship between the nurses and patient thereby promoting quality care and patient satisfaction (Bernard, 2014). The methodology integrates evidence-based practices such as populace-based care administration and various information technologies.
Current Legislative Issue and why it is debated
The American health reforms have often faced opposition from political parties and other stakeholders thereby derailing their implementation. For instance, the Affordable Care Act (ACA) enacted in the year 2010 during the Obama administration still faces contention from different stakeholders. The statue aims at providing affordable universal care to the American citizens through various approaches, such as the PCMH and enhanced insurance cover. Moreover, the law prevents insurance institutions from denying individuals with pre-existing health diseases healthcare coverage and widens the government’s Medicaid health activities for the poor. However, the legislature is controversial as some people claim the law infringes into affairs of individuals and private enterprises (Dalen, Waterbrook & Alpert, 2015). The act also requires a substantial amount of finance to facilitate its execution, hence, can negatively derail economic growth.
People Affected by the Legislation
The most affected people by the legislation are the American citizens that are not employed thus do not have the health insurance coverage. The legislation helps this populace by providing affordable health insurance which can be used to access health services in the PCMH (Lebrun-Harris, Shi, Zhu, Burke, Sripipatana & Ngo-Metzger, 2013). The statute enhances the health outcomes, minimizes disparities in acquiring quality care, and reduces costs of medical expenses through the PCMH approach. Research indicates that more than 22 million people will lose their medical cover if the Republicans appeal the act.
Current Socioeconomic, Political, Cultural, and Ethical Issues Surrounding the Topic
PCMH system is effective in areas with low socioeconomic status since the approach helps decrease the level of inequalities by enhancing access to quality care and coordinated health system. The doctrines that support PCMH have certain challenges such as the principle of respect for the patient independence, which does not need patients to be involved in their health care program. It is ethically unsuitable to make the patient status of engagement a prerequisite for delivery of health service (Braddock, Snyder, Neubauer &Fischer, 2013). The political issues include the high amount of finance required to facilitate the program and its level of effectiveness in lowering health differences. The cultural and language barrier can lead to a type of PCMH that is inept and fragmented.
Stakeholders in Patient-Centered Medical Home Care
Stakeholders are entities that are integrated into the PCMH model and are substantially impacted by the reforms that pertain to the system. In this case, they include the government, patients, physicians, and the insurance institutions. Governmental agencies are incorporated in the development of policies to provide an effective operational environment for the model. Furthermore, the government accumulates and allocates funds for the development of medical homes thereby reducing health disparities. Patients have a moral obligation to their health and creating avenues of minimizing costs. Physicians are the major components of the PCMH system as they are embodied in the responsibility of providing quality and adequate care to the patients (Nielsen, Buelt, Patel, Nichols & Fund, 2014). Similarly, they assist in mitigating the rising costs of healthcare services by agitating for various policies to protect the PCMH. The insurance companies are obliged with the delivery of insurance cover to assist the patient to obtain quality services from the PCMH.
Positions of the Professional Healthcare Organizations, Consumers, and Major Political Parties
The professional healthcare organizations support the PCMH approach that values each stakeholder based on their different capabilities and expertise because the PCMH model promotes access to quality care and averts disparities in healthcare provisions (Nielsen, Buelt, Patel, Nichols & Fund, 2014). Additionally, the consumers back the concept since the method enhances access to care by reducing the cost of medication. However, the Republican Party which is one of the major political parties in the United States is opposing the act based on its intrusion into private business affairs (Fiscella, 2016). It argues that the model requires large funding and deters other insurance agencies from providing the coverage as the government is involved in controlling the insurance syndicates.
The Implication of the Policy for the Nursing Profession
The enactment of the ACA in 2010 significantly changed the nursing profession as the policy encompasses a provision which aims at increasing the number of nurses to meet the rising demand for healthcare. Moreover, the statute enables the nursing student to attain higher loan amounts to facilitate production of more nurses to provide quality care (Brody & Sullivan-Marx, 2012). The ACA offers nurses a chance to progress their careers through increased funding on the nursing profession.
Roles Played by the Nursing Profession in Bridging the Gap in this Health Disparity
The nursing profession plays a significant role in reducing the health differences in the PCMH approach. This is based on the capability to provide security, promotion, and prevention of illness within a person, homes, and communities (Sohn, 2012). The nurses operate jointly with the families, physician, and different stakeholders to enhance quality care at a reduced cost. Some of the policies to be implemented to reduce this degree of health inequality include increasing the funding for health care and promoting the development of medical homes across the country.
PCMH is a medical approach that aims at providing quality care to the patients through a coordinated approach between the physicians, family members, patient, and the community groups. The current legislative issue under controversy is the ACA which has received opposition from the Republican political party based on the high amount of finance required for the program. Individuals affected by the statute include the consumers who are the major beneficiary of the policy. Stakeholders involved in the PCMH technique entails the government, the insurance industry, patients, and the physicians. The program is significantly supported by the health organizations and consumers due to its substantial benefit in reducing health disparities. The nursing profession has the obligation of minimizing healthcare inequality by working with families, physicians, and other shareholders in the delivery of affordable care.
Bernard, A. J. (2014). Effects of patient-centered medical home model on primary care (Doctoral dissertation). Retrieved from https://open.bu.edu/handle/2144/15354
Braddock, C. H., Snyder, L., Neubauer, R. L., &Fischer, G. S. (2013). The Patient-Centered Medical Home: An Ethical Analysis of Principles and Practice. Journal of General Internal Medicine, 28(1), 141-146. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539020/
Brody, A., & Sullivan-Marx, E. M. (2012). The Patient Protection and Affordable Care Act: Implications for Geriatric Nurses and Patients. Journal of Gerontological Nursing, 38(11), 3-5. Retrieved from https://www.healio.com/nursing/journals/jgn/2012-11-38-11/%7B045952c2-c440-41b4-a1d7-ea791184c581%7D/the-patient-protection-and-affordable-care-act-implications-for-geriatric-nurses-and-patients
Dalen, J. E., Waterbrook, K., & Alpert, J. S. (2015). Why Do So Many Americans Oppose The Affordable Care Act? The American Journal of Medicine, 128(8), 807-810. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25731135
Fiscella, K. (2016). Why Do So Many White Americans Oppose the Affordable Care Act? The American Journal of Medicine, 129(5), e27. Retrieved from https://www.amjmed.com/article/S0002-9343(15)00930-4/fulltext
Lebrun-Harris, L. A., Shi, L., Zhu, J., Burke, M. T., Sripipatana, A., & Ngo-Metzger, Q. (2013). Effects of Patient-Centered Medical Home Attributes On Patients’ Perceptions of Quality in Federally Supported Health Centers. The Annals of Family Medicine, 11(6), 508-516. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3823721/
Nielsen, M., Buelt, L., Patel, K., Nichols, L. M., & Fund, M. M. (2014). The Patient-Centered Medical Home’s Impact on Cost and Quality. Annual Review of Evidence, 2015, 202014-2015. Retrieved from www.mpca.net/resource/resmgr/eUpdate/PCPCC-PCMH-evidence-report-F.pdf
Sahasranaman, V. (2016). Affordable Care Act: Patient-Centered Medical Homes and Implications for Mental Health. American Journal of Psychiatry Residents’ Journal, 11(09), 2-4. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2016.110901
Sohn, P. M. (2012). The role of the nurse practitioner in the patient-centered medical home. Retrieved from https://irl.umsl.edu/dissertation/333/