doctors and nurses

Nurse Practioners’ Role in Obamacare

Jan 27 • Health • 2682 Views • No Comments on Nurse Practioners’ Role in Obamacare

On October 25, 2013 at the Saratota Springs Hilton and City Center, the Nurse Practitioner Association of New York gathered to discuss the role of nurse practitioners’ role in Affordable Care Act (Obamacare).

The medical industry is currently going through a series of changes and everyone involved were asking a number of questions What’s changing and staying the same? How will my patients and clients be affected? What’s going to happen with me?

The gathering’s speak, Donna Frescatore (Executive Director of the New York Health Benefit Exchange), said they are working with Washington, D.C.’s Urban Institute to get a grasp on the number of New Yorkers who will need more insurance or demonstrate an increased demand for medical care. The state anticipates over 1 million residents will enroll for Obamacare.

Thirty-four U.S. states will use Healthcare.gov, the exchange for residents who do not have insurance. In 16 states, private companies will offer the insurance plans. New York’s State of Health will oversee the companies that must have a certain number of health providers, but how they do that is managed by the companies, not the state government. Frescatore is currently the executive director of NY State of Health.

Forbes’ Bruce Japsen says Research and Development corporation RAND recently released information that Obamacare will lessen the U.S. physician shortage by “promoting” nurse practitioners and PAs (physician assistants). That analysis is also available in the November 2013 issue of Health Affairs, “Redefining the Health Care Work Force.”

Without the Affordable Care Act, our country’s physician shortage will be critical by 2025, according to the researchers, because the primary care delivery models are going to shift, and they foresee nurse-managed health care centers. This could be a very positive vertical career move for many nurse practitioners, who are already in great demand, assuming that with the increase in responsibility also comes an increase in income. Hospitals and health systems are hiring more new nurse practitioners than ever before.

How It Will Work

Nurses with Grey’s Anatomy scrubs, and other caregivers will manage patient medical care. U.S. states are going to modify the current “scope of practice” laws to allow nurse practitioners and physician assistants to perform more functions. Old-school physicians may have a problem with this. Affordable Health Care Act’s goal is to ensure accountability using ACOs (accountable care organizations). The insurer contracts with providers who offer patient-centered medical centers and clinics to reduce the costs of hospital care. The ACOs reward the providers for teaming up to improve health care quality and lower expenses. When providers attain that goal, they split the money saved.

Most Blue Cross plans are joining ACOs, as well as Aetna, Cigna, WellPoint, United Health Group, and Humana. Walgreens and CVS are also linking with traditional medical care providers to coordinate patient treatment between pharmacy and nurse practitioners.

Walgreen stated, “Our expansion of services earlier this year is helping patients get the right care at the right time, in a convenient and affordable setting from our nurse practitioners and physician assistants,” in an interview with Forbes. “The additional patients gaining insurance coverage as a result of the Affordable Care Act are one of the factors for this service expansion and our plan to open more Healthcare Clinics in our existing markets. We believe this will help meet the significant health care access needs in the communities we serve.”

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