Affordable health insurance for nurses-Personal and Health Insurance for Nurses and Nurse Practitioners | NSO

View all blog posts under Infographics View all blog posts under Nursing Resources. This number accounted for 15 percent of all American citizens, leaving many without the medical attention they needed and deserved. While there still is work to be done, to date, the passing of the ACA has significantly lowered the rate of uninsured Americans, leaving only 9. The changes in uninsured rates have been concentrated to predominately lower- and middle-class income populations. With many Americans falling just slightly over the requirements for low-income health care assistance and other government-funded programs, this news is excellent for those individuals who may have, up until now, not been able to afford coverage.

Affordable health insurance for nurses

Affordable health insurance for nurses

Between andoverdose deaths increased percent in rural counties. Don't call us, we'll call you We know your days are busy. The Affordable health insurance for nurses impacts every part of the U. Coverage of the essential health benefits, as mandated under the ACA laws and regulations, expanded effective and affordable, quality healthcare coverage for millions of Americans, but some have predicted this may also Arfordable up costs of insurance premiums. Lower the cost of health care. Affordable health insurance for nurses existing coverage gaps. Keywords: Health reform, health care workforce, physician supply, registered nurse nursez, microsimulation, insurance, uninsured. Table 5 briefly presents these concepts based on what we know from trends, data, and evidence Patient-Centered Primary Care Collaborative,

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Through the ACA, these investments will continue through With a relatively new doctoral degree in hand, I was offered a position as a legislative assistant in the Washington, D. We love helping nurses find affordable Affordable health insurance for nurses insurance. Health reform GPS. Thus, without the mandate, universal coverage is virtually impossible, as is stabilization of the insurance foundation on which Affordable health insurance for nurses helath health-care system rests. If you are eager to get a quote you can enter your date of birth and zip code at the top of the page and you will get an instant online quote. Support Center Support Center. Buying health care, the individual mandate, and the Constitution. Public Health Rep. Learn how your comment data is processed. As the contours of redesigned health care emerge, nurses can look insurabce to a multitude of new opportunities. After all, I was a tenured nursing professor at the University of North Dakota, with a Rosemead asian pacific clinics academic career path ahead of me. These clinics train new nurses while delivering primary care to vulnerable populations, such as public housing residents. Author information Copyright and License information Disclaimer.

Yet nearly 27 million Americans still lack health insurance.

  • Full implementation occurs on January 1, , when the individual and employer responsibility provisions take effect, state health insurance Exchanges begin to operate, the Medicaid expansions take effect, and the individual and small-employer group subsidies begin to flow.
  • There are a variety of health insurance plans available for nurses.
  • I first provided patient care when I was in high school, working part-time in a small, rural hospital and nursing home in my hometown of Devils Lake, North Dakota, USA.

Already a member? Sign in. The Patient Protection and Affordable Care Act, its history, and what healthcare will look like during and after implementation are addressed in this article. A discussion of the role and value of nurses in healthcare reform accompanies knowledge-building and action-oriented resources available to nurses and clients.

As nurses, we are watching and experiencing healthcare reform as both professionals and citizens. The nursing profession is now placed in a unique position to facilitate development of patient coordination including identification of key points in client care to manage wellness and illness as well as systematic measurement of health outcomes. When President Obama signed the Patient Protection and Affordable Care Act on March 23, , a collection of laws was created that, as a whole, put in place comprehensive healthcare and health insurance reform.

The development of these laws began much earlier with legislation and regulation designed to create a patient's a bill of rights, encourage the use of evidence-based best practices, and increase access to affordable healthcare.

This legislation represents a complex series of changes. The ACA has had early success in implementing these reforms and preserving the structure of care Jost, It is predicted that new and younger people entering the healthcare market will drive the costs of healthcare down. Still, to date, many of the benefits of the ACA remain largely unseen. The No. By addressing the cost of healthcare, as well as issues of access to healthcare, better health and financial stability are possible for individuals, businesses, and government.

Historically, U. Effective healthcare and good and affordable health for any population result from high-quality, affordable, and accessible care Lamb, These three points are frequently represented by disparate and disconnected industries, often industries that are competing with each other rather than working together to maintain good health for their clients. The "triple aim" of health reform, and of the ACA, is to 1 improve the patient experience with higher quality care, 2 increase access to care, and 3 control healthcare costs Institute of Medicine, Competition between disconnected organizations is demonstrated in our traditional fee-for-service healthcare system.

Services must represent appropriate interventions and expected outcome based on the client's goals of care. While quality is inherently measured and valued in healthcare, it has not often been paid for or incentivized. The ACA promotes healthcare that is designed within coordinated, orchestrated, and value-based care models. Value-based care incentivizes healthcare providers to keep population groups healthy by focusing on outcomes of care rather than volume of service of care.

Value-based care incentivizes healthcare organizations to meet benchmark health outcomes for their clients.

This also creates healthcare systems that are focused on wellness, prevention, minimizing repetition, and unnecessary costs. Nurses are key players in this component of healthcare reform. Uniquely situated on the front lines of patient care, as well as within healthcare payer and supplier agencies, nurses have the expertise and obligation to influence practice and policy Institute of Medicine, Nurses promote health, navigate chronic illness, and prevent the development of secondary conditions, all of which align with the triple aims of healthcare reform.

As hospitals, insurance providers, and provider groups align to be a part of value-based payment systems, the roles of nurses become integral to promoting these changes. Care managers, care coordinators, and informatics experts- nurses -are vital leadership for directing care process changes, quality and evidence-based interventions, and measurement of care outcomes Lamb, Nurses have a demonstrated history of leadership in team-based care processes. Nurses have patient-centered care as a core professional standard and competency.

Nurses are pivotal to care quality and patient satisfaction, as well as efficacious use of resources to provide patient-centered and evidence-based care. Health Insurance MarketPlaces are centralized sources for state-level information on the options and costs for individuals and small businesses when purchasing affordable healthcare coverage. Individuals use the MarketPlace to determine whether they qualify for insurance premium subsidies subsidies are cost sharing reductions or government-sponsored programs based on income.

States were given the option to develop their own State MarketPlace or to use a state-based but federally developed MarketPlace.

In October , the Federal MarketPlace launched with many technical challenges. People will continue to access the online MarketPlace individually but in-person navigators are also available to help individuals understand their options and the enrollment process.

Open enrollment via the MarketPlaces officially closed March 31, Until the next open enrollment period, the MarketPlace remains open for enrollment for individuals and families experiencing qualifying events such as job loss and changes to family composition. As nurses, we are always challenged to teach clients about the healthcare delivery system and the ACA has significantly increased the need for these efforts.

Many clients are confused with their options and the processes for obtaining and accessing health coverage. For example, new users may be surprised that the plans they selected are low cost in monthly premiums and unaware those will typically translate to higher deductibles, even though the deductibles are typically below policies outside of those offered at the MarketPlace Jost, Nurses may find themselves overwhelmed by the education and information needs of their clients.

Below are three tables: a list of definitions see Table 1 and lists of resources for client questions see Table 2 and valuable resources for you as a nurse see Table 3. There are new requirements for the healthcare benefits offered in any Qualified Health Plan. No longer can policies be offered that do not provide "Essential Benefits" such as preventive care or comprehensive care or maternity benefits, for example see Table 4.

Previous to the ACA individual insurance policies often lacked these basic levels of coverage. Coverage of the essential health benefits, as mandated under the ACA laws and regulations, expanded effective and affordable, quality healthcare coverage for millions of Americans, but some have predicted this may also drive up costs of insurance premiums.

Interesting components of these essential services are worthy of discussion. For instance, the additional requirement of mental health and behavioral health, including counseling and psychotherapy, has resulted in many primary care organizations developing integrated physical and mental health services for their clients.

Those with chronic illness now have access to ongoing therapy services to help them achieve optimal function. New wellness and prevention and behavioral health services are quickly being expanded into the traditional service lines of primary care, medical homes, family practice, and outpatient services. Accountable care organizations ACOs , a Medicare Pilot Program under the ACA, is a way of organizing care delivery that establishes a system of value-based payment contracts for large populations of the insured.

The ACO model allows Medicare, and other payors of healthcare, to contract with providers for services based upon benchmark health outcomes for their clients. Though still a fee-for-service model, the ACO payment structure is based on financial incentives to improve benchmarks. For example, an ACO may negotiate that a majority of their clients will have controlled blood pressure levels. If the ACO attains the agreed-upon benchmark for their population of their clients, the ACO will share in the savings achieved rather than the insurer keeping all those savings.

Incentivized, benchmarked, value-based outcomes system is the heart of creating an ACO framework as a method of healthcare reform. To set and measure benchmarks for quality and cost, we must first reach agreement on accurate measures of quality.

This requires available informatics systems capable of tracking and reporting outcomes data in an ACO. This highlights the importance of new health information technology requirements rolled out in the ACA.

Many clinical groups and providers did not have adequate systems for ACO participation; thus, the ACA also offered provider networks funding to upgrade and implement information systems. An ideal model for healthcare delivery reform addresses four key concepts integral to the sustainability: 1 access, 2 care coordination, 3 healthcare information technology, and 4 payment reform Patient-Centered Primary Care Collaborative, Table 5 briefly presents these concepts based on what we know from trends, data, and evidence Patient-Centered Primary Care Collaborative, For nurses, being a part of an ACO means being a part of integrated, interdisciplinary teams collecting measurements of health outcomes, being aware of how those outcomes are cared for in their system, and assuring the interventions provided to clients are effective, efficacious, and evidence-based.

Important to nursing and healthcare science is that we focus on preventing illness and promoting wellness in our care teams by using evidence-based strategies Grady, Integrated teams of care providers will play a major role in applying evidence-based practice to the populations we care for. Now as new services become available to our clients, such as behavioral and mental health, care teams are challenged to integrate services across disciplines. Coverage of obesity counseling for orthopaedic clients can be paid for under the ACA, coverage for substance abuse, smoking cessation, or other services not previously covered services, are now being provided.

As the client moves between all types of care services offered, care managers will be monitoring health outcomes and connecting to services. For example, a nurse in an outpatient orthopaedic clinic or a clinician at a behavioral health counseling session could also be monitoring and coordinating efforts to address a client's hypertension.

Integrated clinics specializing in personalized healthcare are showing up in our communities. Integrated care means that nurses may be working in an internal medicine clinic as a care manager, navigating patients through bundled care services and assuring the care bundle developed by their organization are being completed for each client.

A variety of clinicians are needed to achieve the goals of this care bundle. To support measuring the outcomes of a bundle, systems need informatics, tracking, assessment, and a team of coordinated care providers. Care managers will be monitoring all of the clients, but they may be supervising medical assistants calling clients for check-ins or scheduling appointments; thus, leaving their time for one-on-one sessions reviewing needed teaching or scheduling a healthcare advocate to make home visits to assess a client's falls risk.

Healthcare providers are becoming connected in new ways. One example may be that the pharmacy would note that a client has not picked up a refill of a medication, and alert the care management team to initiate a call to the client to see what they can do to help the client stay on their medications.

Another form of connection would be a care manager alerting a primary care provider when their clients are within the goals of health outcomes and prompt the primary care providers about what could be discussed or revised for the client to improve these goals. Gone are the days when one care provider can be expected to track, remember, and measure all of the outcomes that are now known as basic care for diagnoses or conditions.

Teams are needed to provide quality, evidence-based best practices, examine evidence, make system changes, and ultimately interface with the client to bring quality healthcare to their lives. The examples described previously highlight where nurses are uniquely situated to affect patient outcomes within the work of an ACO.

Nurses possess a theoretical base of biophysical, psychosocial, and developmental knowledge. All are skills that nurses have and can continue to develop. The ACA of enacted a large group of laws that brought change to processes, systems, payers, and users of healthcare.

This is not the first time that reform of our private, market-based healthcare system has been attempted. Kennedy, Richard Nixon, and Bill Clinton all ventured into lobbying and legislation for reforming healthcare delivery. These leaders, and others, settled for incremental changes to the system and no comprehensive reform occurred; this left us with fractured, disconnected, and competing systems paying and providing healthcare to our nation.

Congressional Budget Office. Updated estimates of the effects of the insurance coverage provisions of the Affordable Care Act, April Centers for Medicare and Medicaid Services. Grady P. Charting future directions in nursing research: NINR's innovative questions initiative. Journal of Nursing Scholarship, 46 3 , Hartman M.

National health spending in Overall growth remains low, but some payers and services show signs of acceleration. Health Affairs, 32 1 , Himmelstein D.

All the plans we quote are the lowest rates approved by the department of insurance. United States v Lopez, U. In advance of the effective date for the mandate, the subsidies, and the Exchanges, the Act permits states to expand Medicaid for low-income adults as a state option; states also, at their option, may extend coverage for family planning services to the low-income population. N Engl J Med. PPO Plan: Also known as a Preferred Provider Plan, this plan offers discounts on health care if you visit doctors, clinics, specialists and hospitals that are on their list of preferred providers.

Affordable health insurance for nurses

Affordable health insurance for nurses

Affordable health insurance for nurses

Affordable health insurance for nurses

Affordable health insurance for nurses. What’s the Job Outlook Nurses?

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What Does the Affordable Care Act Mean for Nursing? | CE Article | NursingCenter

To predict changes in wage growth for health care workers based on projections of insurance enrollment from the Affordable Care Act ACA. Enrollment data came from three large employers and a sampling of premiums from ehealthinsurance.

Information on state Medicaid eligibility rules and costs were from the Kaiser Family Foundation. Bureau of Labor Statistics data were used to estimate employment.

We projected health insurance enrollment by plan type using a health plan choice model. Using claims data, we measured the services demanded for each plan choice and year. Changes in wages resulting from changes in labor demand from to were based on labor supply and demand elasticities. Expenditures required to retain and grow the health care workforce will increase substantially. The largest impact will be felt in Projected wage increases for health care workers may drive substantial growth in insurance premiums and reduce the affordability of health insurance.

This study seeks to understand how the Affordable Care Act ACA will impact the demand for health care workers and their wages. Because the ACA will increase the population covered by health insurance, the demand for health care services, and thus providers, is expected to increase.

What wage increases will be necessary to bring the supply of health care providers, including physicians, nurses, medical aides, technicians, and home health aides, in line with the new level of demand? The labor market for each health occupation is distinct due to differences in licensing regulations, educational requirements, and skill; thus, the ACA should impact each labor market differently.

By anticipating gaps between demand and supply, and resulting wage inflation, we can better develop policies to address the need for health professionals and prepare for the impact of rising wages on health care costs and insurance premiums. The ACA impacts every part of the U.

States have the option to use federal dollars to expand their Medicaid programs for all adults with household incomes below percent of the federal poverty level. In addition, some predictions suggest that better access to primary care resulting from the insurance expansion may reduce emergency department visits and hospital admissions Bodenheimer and Pham Having insurance to cover prescription drugs may limit the need for doctor visits in some patient populations.

Population growth will require 33, additional physicians, aging will increase demand by another 10,, and insurance expansion will account for about 8, additional physicians, a 3 percent increase in the primary care physician workforce. Other studies have estimated smaller increases in the demand for primary care providers.

Adopting the Congressional Budget Office's estimate of an additional 32 million insured, they found that the demand for primary care visits will increase by Department of Health and Human Services estimates that up to 20, additional primary care physicians will be required by , with 19 percent of this increase due to the ACA and the remainder to aging and population growth U.

Other research has found that the ACA will impact the demand for medical specialists. Including both the impact of the ACA and demographic change, total growth by was projected to be 14 percent for primary care and over 30 percent for vascular surgery.

It is difficult to extrapolate the Massachusetts experience to the entire nation because health workers can move across state lines to meet the increased demand for health care workers in one state. The health professional labor market may not function perfectly across state lines, however, due to medical licensure laws that often require licensure in the state of practice. These licensure laws generally confine the labor market to the United States because it is difficult for providers trained in other countries to enter the U.

Previous research has not studied the impact of a nationwide expansion of health insurance coverage on wages for physicians, nonphysician medical providers, and administrative professionals. One of the few studies that examined a national health insurance expansion found that expansion of the State Children's Health Insurance Program in had little impact on provider utilization White In summary, the workforce literature—while robust—is not able to provide reliable estimates of the ACA impact on either labor force projections over time or wages.

The model includes employer and individually purchased insurance, Medicare and Medicaid. Parente and Feldman estimated that 7. The consumer's age, gender, income, and household size are accounted for by interacting them with plan characteristics. Plan enrollment from to was predicted under different ACA scenarios.

The number of uninsured under age 65 drops from 44,, in to 22,, in when everyone who is predicted by the model to sign up for coverage has done so. Thereafter, the number of uninsured begins to increase slowly again. This is due to further increases in health insurance premiums, which are only partly offset by the ACA subsidies. While the ACA will affect enrollment in each sector e. Here, the number of uninsured increases to 60,, in The model uses nationally representative claims data from multiple employers and private payers to estimate the use of medical services per person by type of private insurance plan.

Due to limitations in the claims data, the ARCOLA model does not estimate utilization of nonhospital outpatient services, such as physical therapy in freestanding centers, nonhospital radiology and laboratory tests, and ambulatory surgery in freestanding surgery centers.

We assumed that the rate of growth in these services will be proportional to the rate of growth of office visits. We calculated total services demanded by plan and year from to by multiplying the projected number of individuals in each plan type in each year by these average utilization projections.

According to our claims data, there were 2. Hospital admissions increased from 0. RAND found that total admissions increased by 29 percent, which is slightly less than our estimate but within a reasonable range.

Because our estimates of a large increase for outpatient care and no increase for admissions differ from the Oregon findings, we adjusted the claims to match the Oregon data. Bureau of Labor Statistics We allocated incoming professionals into care settings based on their employment settings in The annual growth in demand for physicians due to the ACA ranges from a low of 0. The cumulative growth in demand for doctors is Note that this Given that supply and demand for doctors are inelastic, a shift in demand of this size will push up wages by a substantial amount.

Less affected are home health aides, registered nurses, and technical positions. We also estimated the number of newly licensed providers expected to enter the labor market, based on current enrollments and graduation trends. To predict how changes in demand and supply will affect wages, we needed to link the change in demand and supply for labor inputs with the elasticities of demand and supply for the inputs.

To do so, we started with the demand and supply functions for an input:. We estimate X D but treat X S as exogenous because it represents doctors or nurses in the training pipeline. It follows that the input price elasticity with respect to the net shift in demand is:. As these increase, the input price elasticity decreases. The elasticity of supply of some inputs may be lower less responsive to price in the short run due to the length of the training period or supply bottlenecks.

The model also includes a lag in wage adjustment because some health care workers are employed in multiyear contracts that are renegotiated at fixed intervals. The National Sample Survey of Registered Nurses in found unionization rates of 6 percent of nurses in ambulatory care, Unionized workers are likely to be covered by multiyear labor contracts that will adjust over time to the new demand conditions of the ACA.

We project significant wage increases for all workforce categories in the ACA scenario compared with the baseline. At the high end, physician wages grow 30 percent from to in the ACA scenario, compared with baseline growth of In contrast, home health aides are projected to see 6 percent wage growth from to compared with 3.

As the graphs below show, the key years for wage growth are and , after which growth rates stabilize. Like physicians, registered nurses go through multiple years of training to enter the profession and thus the labor supply is less elastic.

Without the ACA, wage growth is projected to be 8. As with other professions, the highest wage growth occurs in and Medical technicians are projected to have moderate wage growth of 6.

Annual growth rates for this group are relatively low, exceeding 1 percent only in and Licensed practical nurses also are projected to see moderate wage growth of 7. Assistants and aides are projected to see the same wage growth rate as licensed practical nurses, 7. Unlike the other professions, higher growth rates for medical aides persist throughout our forecasting period as the wage growth curves for the other occupations return to baseline levels after Home health aides are projected to have the lowest wage growth of the professions studied: only 6 percent from to However, this is double the 3 cumulative percent wage growth in the baseline projection.

As with other workforce categories, home health aides see wage growth increasing relative to the baseline in and , and then growth rates return to the baseline once they have adjusted to meet the rising demand.

This analysis has several limitations. The first is that we made numerous assumptions to complete the complex analyses both in the ARCOLA model and in the wage elasticity estimates. In addition, expansions in undergraduate medical education programs, medical residencies, and nursing schools including nurse practitioner programs could dampen the wage growth we predict.

Another key assumption is that rates of medical claims and provider productivity will be constant. New treatments, new models of care e. Although HIT is often identified as a key source of potential efficiency improvements, recent evidence Lee, McCullough, and Town indicates that HIT may have limited potential to reduce costs, at least in the near future. Finally, there may be regional differences in labor markets, as well as differences across subgroups within professions such as physician specialists versus primary care physicians.

With physicians already accounting for 24 percent of personal health care spending, 3 thirty percent wage growth from to would put tremendous strain on patients' resources and the federal budget. Registered nurses are the largest health care occupation, and the largest expense in hospitals, so the projected wage growth of The only point of reference for the effect of the ACA insurance expansion on wages is the Massachusetts expansion in We compared trends in RN wages in Massachusetts before and after to national trends.

We expected to see a break after , with nurses in Massachusetts gaining relative to the national average after health reform. Perhaps Massachusetts had permanent excess demand for nurses, before and after health reform.

If these administrative occupations required clinical training, such as care management positions, that may explain some of the labor market impact among nurses. Source : U. We considered the effect of uncertain provider pricing from the new Medicaid expansions on physicians' wages. Our analysis captures differences due to demographic factors e. However, the Affordable Care Act required that states increase Medicaid primary care fees to at least the Medicare levels in and The federal government funded percent of the increase until December 31,

Affordable health insurance for nurses