Margaret Clark Graham

Healthcare reform: what does it mean for NPs?

The Affordable Care Act was signed into law on March 23, 2010. Since the passage of the law, there have been more than 20 court challenges and plans for repeal are underway. This article will review the provisions of the law that have been implemented to date.

Implementing team-based care.

The delivery of team-based care has been a topic of several landmark publications, yet implementation and integration of interprofessional team-based practice is not readily seen in primary care. As healthcare delivery continues to evolve, many experts are stressing the importance of team-based care in an effort to deliver higher-quality, lower-cost care to patients. The idea of team-based care is not new and was addressed in the 1972 Institute of Medicine (IOM) Conference Report, Educating for the Health Team. This report recommended interdisciplinary education for health professions that would allow each discipline to practice to their full scope and present role models of cooperation between healthcare professionals.

Medicare reimbursement and the sustainable growth rate formula.

On February 17, after weeks of debate, Congress agreed to extend the payroll tax cut until the end of 2012. This agreement also extended the “Medicare Fix.” 2 Discussion surrounding the extension of the U.S. payroll tax cut dominated the debates in the Senate and the House in the week leading up to the December Congressional recess in 2011. At that time, the extension was for 60 days. The February extension moved the

Creating a heart healthy future with the Million Hearts initiative.

As nurse practitioners (NPs), we frequently refer to ourselves as “prevention specialists”; however, in many reimbursement systems, prevention has proven to be challenging due to payment systems based on an illness model and no reimbursement for wellness or prevention. When NPs’ salaries are based on productivity and reimbursement is based on treating disease during time-limited visits, prevention may get short changed. Fortunately, due in part to the Affordable Care Act, healthcare providers are being given the opportunity and the incentive to practice prevention. The Million Hearts initiative is one such opportunity. Million Hearts is the new publicprivate sector initiative aimed at preventing 1 million myocardial infarctions and strokes in the next 5 years. The initiative will bring together a number of programs, policies, and campaigns designed to help reduce cardiovascular disease. Public and private organizations partnering with HHS in the Million Hearts initiative include the Centers for Medicare and Medicaid Services (CMS), CDC, the American Nurses Association, the American Medical Association, and the American Pharmacists Association. HHS has pledged to target more than

Accountable care organizations: the future of healthcare?

200 million in new and refocused investment to achieve the goals of the Million Hearts initiative. The Million Hearts initiative is focused on two goals: 1. Empower Americans to make healthy choices in the areas of tobacco cessation and reducing transfat and salt in the diet 2. Improve care for people who need treatment by encouraging a targeted focus on the ABCs: • Aspirin for people at risk (baseline 47%, 2017 goal 65%) • BP control (baseline, 46%; 2017 goal 65%) • Cholesterol management (low-density lipoprotein cholesterol [LDL-C]) (baseline 33%; 2017 goal 65%), and • Cessation of smoking (prevalence 19%, 2017 goal 17%).