Author Archives: Brandee Dodd
Why “care coordination” and why now? Care coordination has been proposed as a solution to many of the seemingly intractable problems of American health care: high costs, uneven quality, and too frequent disappointing patient outcomes. More resources are devoted to health care per capita in the United States than in any other nation, yet our fragmented system is often characterized by communication failures and non-beneficial or redundant healthcare tests and services. This results in an unacceptable risk of error and an increase in cost, in terms of both resources and human suffering.
Many independent elements of U.S. health care are high quality, but these need to be better aligned to serve patients and the people and institutions that care for them. Current financial and structural incentives restrict potential for better patient care outcomes and effective resource allocation. Rather, they intensify the weaknesses inherent in the non-coordinated, independently functioning pieces of our health care system. The development and implementation of effective systems and processes to cure this current misalignment can benefit tremendously from the experience, professional competencies, and long-standing ethos of registered nursing.
Coordination of care is not a new idea, and it is certainly not new to registered nurses. In the context of a partnership guided by patients’ and families’ needs and preferences, the registered nurse is integral to patient satisfaction and care quality, as well as the efficient use of health care resources. Patient-centered care coordination is a core professional standard and competency for all nursing practice. Registered nurses understand that they are an essential component of the care coordination process to improve patients’ care outcomes, facilitate effective inter-professional collaboration, and decrease costs across patient populations and health care settings. What is well known to registered nurses, however, has not often been recognized outside of nursing. This white paper was initiated to highlight both the qualitative and quantitative accomplishments of registered nurses in care coordination.
More than 18,000 interviews have been conducted with
employers within the United States, including all 50 states,
the top 100 Metropolitan Statistical Areas (MSAs), the
District of Columbia and Puerto Rico, to measure hiring
intentions between January and March 2014. The mix of
industries within the survey follows the North American
Industry Classification System (NAICS) Supersectors and
is structured to be representative of the U.S. economy. All
participants were asked, “How do you anticipate total
employment at your location to change in the three
months to the end of March 2014 as compared to the
Among U.S. employers surveyed, 17 percent expect to
add to their workforces, and 7 percent expect a decline in
their payrolls during Quarter 1 2014. Seventy-three
percent of employers anticipate making no change to staff
levels, and the remaining 3 percent of employers are
undecided about their Quarter 1 2014 hiring plans.
How Healthcare Reform Will Likely Impact Hiring
Demand for the services of healthcare workers will increase.That much we can say about healthcare hiring in the wake of the passage of the Patient Protection and Affordable Care Act. In its 1,000-plus pages, the reform legislation’s broad-stroke system changes and neuron-numbing details will not only create jobs; the far-reaching plan will also change the career paths of many experienced or aspiring health professionals as the system lumbers toward universal coverage with an emphasis on primary care.
But what clinical positions will healthcare organizations need to fill to meet the increased demand, and when? Much won’t be known for a few years, as the new law’s many provisions make their staged entrances. Still, the legislation’s major emphases will have somewhat predictable effects on the healthcare labor economy.
And what will be the magnitude of job creation? Perhaps not as enormous as some of headline healthcare-reform numbers suggest.
Because Medicare today covers virtually the entire population age 65 and up, nearly all of the estimated 32 million people who will become covered under healthcare reform by 2014 are younger Americans who require fewer healthcare services. And “uninsured Americans already receive about 50 percent of the care they will receive when insured,” says Charles Roehrig, director of the Altarum Center for Studying Health Spending, a research and consulting organization with clients in government and the private sector.
So it turns out the total increase in provided healthcare will be about 3 percent, Roehrig says. And since younger patients use more ambulatory care, outpatient services will see the greatest increase in demand.
A Greater Mix of Providers for Preventive, Primary Care
The reform law’s emphasis on primary care will have cascading effects on several clinical occupations. “Physicians can’t be trained overnight, so healthcare employers will leverage their M.D.’s with nurse practitioners and physician assistants,” says Roehrig. “Everything will be pushed so that everyone is performing right up to their education level.” Along with these licensed providers, demand for medical assistants will see a boost, he adds.
And the pressure to move some tasks off the plates of physicians won’t stop at hospitals and more states will license them to practice on their own,” says John Salerno, DO, a family physician in New York. As the demand for advanced-practice nurses rises, the perennial shortage of bedside RNs will likely intensify.
“With the increased demand for NPs, there will be further demand to backfill for RNs,” says Pete Ferguson, senior vice president for health and life sciences at staffing firm Yoh Services. So savvy healthcare employers are beefing up their perennial efforts to keep students and experienced nurses in the recruitment pipeline, even through this time of tight budgets.
By: John Rossheim, Monster Senior Contributing Writer
The Health Insurance Marketplace helps uninsured people find health coverage. Fill out the Marketplace application and we’ll tell you if you qualify for:
•Private health insurance. Plans cover essential health benefits, pre-existing conditions, and preventive care.
•Lower costs based on your household size and income. You can preview plans available in your area right now, with prices based on your income and household size. Most people who apply will qualify for lower costs.
•Medicaid and the Children’s Health Insurance Program (CHIP). These programs cover millions of families with limited income. If it looks like you qualify, we’ll share information with your state agency and they’ll contact you. Many but not all states are expanding Medicaid in 2014 to cover more people. Find out what Medicaid expansion means for you.
Most people are eligible to use the Marketplace. Learn more about immigration status and eligibility.
Most people must have health coverage in 2014 or pay a penalty. If you don’t have coverage, you’ll pay a fee of either 1% of your income, or $95 per adult ($47.50 per child), whichever is higher. You’ll pay the fee on your 2015 income taxes.
Some people qualify for an exemption to the fee, based on income or other factors.
You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.
You can also buy a plan outside the Marketplace and still be considered covered. If you buy outside the Marketplace, you won’t be eligible for premium tax credits or lower out-of-pocket costs based on your income.
If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance isn’t considered affordable or doesn’t meet minimum requirements.
If you have Medicare, you’re considered covered and don’t have to make any changes. If you have Medicare, you can’t use the Marketplace to buy a supplemental plan or dental plan.
Trusted by over 1 million nurses across America, Nurse.com is the most effective way to complete your continuing education requirements, and get the tools you need to thrive.
Go to http://ce.nurse.com for more information on CE Training
Classroom” (http://ce.nurse.com/course/ce595/teaching-tomorrows-nurses), I want to thank you for focusing on the value of technology in education.
People learn in a variety of ways, and no two students learn exactly the same way. It is for this reason that educational uses of technology are so important to nursing students. Traditional lecture supports students that learn through listening, but a combination of lecture, visual clinical skills demonstrations, videos and simulation labs appeals to audio, visual, and tactile learners. This can be done through utilization of computers, tablets and smartphones combined with traditional lecture in the classroom.
These various methods of learning appeal to a broader range of students, thus creating more competent student nurses. Therefore, there is not just a need for more nursing educators, but a need for nursing educators who can support and empower more students by increasing the nursing knowledge base through utilization of various forms of technology. The potential for learning through technology is unlimited!
— Aishling Robinson, RN, BSN