South Florida Hospital News
Friday August 23, 2019
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May 2010 - Volume 6 - Issue 11

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Nursing and Healthcare Reform

Health care reform was brought to life in a storm of controversy. Since being signed into law by President Obama, debate continues on the impact it will have on the Nation’s healthcare system, economy, and deficit, and on the lives, wallets, and fate of Americans, whether or not they have health insurance today. The procedural framework for healthcare reform will now undergo rule-making by the agencies overseeing its implementation, and it is timely for nurses to examine closely how these changes will affect the profession and those for whom they care.

It is projected that reform will result in an extension of coverage to an additional 32 million Americans by 2019. A new mandatory floor of $11 billion has been set to expand capacity of our national network of community health centers, and investments will be made in the National Health Service Corps, school-based health centers, nurse-managed health clinics, and hospital emergency department capacity, including a new trauma center initiative which will fund research on adult and pediatric emergency care and the design and demonstration of innovative models for emergency care systems.

In extending access to millions of new consumers while eliminating financial disincentives such as co-pays and deductibles, healthcare reform will substantially increase near term demand for primary care services. These new demand pressures are likely to balloon the current US shortage of primary care physicians from the current range of 5,000 to 13,000 to as many as fifty-thousand. It’s equally likely that better primary care reimbursement and the new law’s goal of expanding primary care residencies will in time yield greater numbers of primary care physicians. In the short term however, as demand swells and the physician gap widens, there can be little doubt that we’ll see a greater leveraging of nurses, in primary care settings, to help meet the sharp spike in demand. Yet other provisions of the law will create new opportunities for nurses to provide workplace wellness services, disease and case management services, and to engage in funded research and program development initiatives.

These new opportunities will surely encourage setting migration causing nurse vacancies that will have to be filled elsewhere. As we cast our thoughts to the broad effects of reform, and to interacting effectively with healthcare reform’s rule-making process, the nursing profession needs to ask three closely-tied questions: (1.) What are the ways in which healthcare reform influences the demand, the supply, and the re-distribution of nursing and health services? (2.) How do the coming changes interact with a profession already under stress as a function of a national shortage of nurses, a shortage which has only temporarily and unsustainably been quelled by the current recession? (3.) What, strategically, should we be doing now to ensure that reform will be implemented in a manner that strengthens the field, helps close the gap in demand and supply of nurses in all areas and at all levels, and captures for nursing and for the health and well-being of healthcare consumers the opportunities of the new healthcare environment?

Nursing has an obligation to respond systematically and simultaneously to healthcare reform and to the post-recession, post-reform nursing shortage. If the gap in healthcare workforce demand and supply is to be effectively managed in light of a substantial healthcare expansion, it is critical that the rule-making process, likely to unfold over multiple years, be properly informed by the nursing profession and address— as far as the new policy framework can — the urgency of bolstering the nursing workforce and preparing it for the challenges ahead.

Certainly the heads of nursing’s leading professional organizations and interested partners including foundations such as the Robert Wood Johnson Foundation, and suppliers like Johnson & Johnson must continue to leverage their close collaboration to claim seats for nursing at every table at the federal level. Similar engagement at the state and local level is equally critical. Key rule making and legislative activity will be taking place in Washington, DC, AND in Tallahassee. If we seize on the opportunities, ours can emerge as the region most distinguished in Florida and the nation for consistently producing the highest clinical outcomes and patient satisfaction measures.

We can be the innovation leaders and the ones to most quickly implement best practices broadly. Achieving such goals in an era of greater information and transparency will insure the region’s continued growth as a healthcare destination, and will greatly contribute to the mental, physical, and economic wellbeing of South Floridians. This is the principal objective of the Nursing Consortium of South Florida and the reason that many of the region’s healthcare institutions, nursing schools, and others are engaged in its initiatives. We look forward to continuing to do more, together, and invite others to join us.

Ralph Egües, Jr., Executive Director, Nursing Consortium of South Florida, can be reached at (305) 669-9644 or egues@nursingconsortium.us.
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