Changes Introduced to Reform and Restructure the U.S. Health Care Delivery System

Current Federal Healthcare Regulation Meant to Restructure the Health Care Delivery System and its Effect on Nursing Practice and the Nurse’s Role and Responsibility

Healthcare reform has remained an emotive and controversial issue in the United States. According to Jacobs and Skocpol (2016), the majority of Americans believe that healthcare is a basic need that should be accessible to everyone irrespective of their race, religion, gender, financial status, or any other demographic factor. However, coming with proper laws that define how such care should be financed is still a major issue. The most recent healthcare reform law that was passed in the United States is the 2010’s Patient Protection and Affordable Care, also known as the Affordable Care Act or Obamacare (Buckley, 2020). When President Trump came to power, he tried to introduce the American Health Care Act but it could not pass through both houses. As such, he signed Executive Order 13813, which focused on restructuring most of the aspects of the healthcare delivery system as defined in the Affordable Care Act (Buckley, 2020). The current federal regulation introduced by the current regime has a major effect on nursing practice and nurses’ roles and responsibilities. As Kimuyu (2018) observes, the role of a nurse is to provide care and support to patients irrespective of their financial capabilities. The new law may make healthcare services unaffordable to some patients. Such situations may complicate the work of nurses who may be forced to deny patients services they deserve.

How Quality Measures and Pay for Performance Affect Patient Outcomes

Quality measures and pay for performance have a significant effect on patient outcomes. According to Jacobs and Skocpol (2016), when a healthcare facility takes seriously the need to offer quality care, patients will receive the best service delivery possible at the institution. Factors such as the time when services are delivered and the approach of attending to patients will improve. Pay for performance tends to improve the morale of the medical staff. It makes them feel that their effort is appreciated. Quality measures and pay for performance affect nursing practice. They define the culture that an organization embraces in terms of offering care to patients. Nurses expect the management of institutions they work for to adopt and promote quality assurance policies and fair remuneration plans to enable them to undertake their primary role and responsibility of care and protection. However, it is important to note that these healthcare facilities need a reliable revenue source to sustain their operations. If the government cannot finance their healthcare needs through effective insurance coverage, then patients may be forced to find ways of paying for such services.

Professional Nursing Leadership and Management Roles

Changes recently introduced to reform and restructure the United States healthcare delivery system have led to new nursing leadership and management roles because of the emerging issues. Kimuyu (2016) argues that nurses are gaining a new role of being counselors in institutions of healthcare. In the process of providing quality healthcare and promoting patient safety in diverse settings, nurses interact with patients more than any other healthcare professional. As such, they find themselves having to address the financial challenges that patients face. Some of them often fear that they may be denied services because of the lack of proper insurance coverage. Buckley (2020) explains that the mental health of a patient may affect their ability to recover from a given condition. Nurses have to take a new role in assuring these patients that their issues will be addressed. Sometimes they have to demonstrate leadership by helping these patients to find ways of financing their medical bills. The new responsibilities may not be clearly defined in the primary role of a nurse, but they are essential in responding to emerging trends in the healthcare sector. As new laws emerge, nurses are forced to redefine their role within the healthcare sector. Besides providing care for patients, they now have to take into consideration the emotional and financial needs of patients under the new federal regulations.

Emerging Trends

New trends are emerging in the healthcare sector in direct response to the current and emerging federal and state healthcare regulations. As Buckley (2020) notes, Executive Order 13813 has made healthcare services relatively more expensive than they were before, especially for low-income Americans. One of the major transformations witnessed in nursing practice is the new role of acting as counselors for financially troubled patients. Within the next five years or more, this role may become one of the basic services that nurses have to provide in response to upcoming trends in healthcare. Another major transformation likely to be witnessed is that nurses will become advisers to their patients on issues about appropriate healthcare insurance solutions. As Kimuyu (2018) observes, the majority of patients, including those in the middle class, are not aware of the best covers they can take. A significant number of the population relied on the government-sponsored programs as was outlined in the Affordable Care Act of 2010. Nurses have to take the new role of helping their patients to get appropriate cover from many institutions offering the same.


Buckley, J. F. (2020). Mandated benefits 2019 compliance guide (IL). Wolters Kluwer.

Jacobs, L. R., & Skocpol, T, (2016). Health care reform and American politics: What everyone needs to know (3rd ed.). Oxford University Press.

Kimuyu, P. (2016). Impact of the US healthcare reform on various levels. GRIN Verlag.

Kimuyu, P. (2018). The role of managed care organizations within the healthcare industry. GRIN Verlag.

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