xamine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment. Include the following: You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. Purchase the answer to view it


The U.S. health care delivery system has undergone significant changes in recent years to address various challenges and improve the provision of care. These changes have been driven by factors such as rising health care costs, access issues, and the increasing complexity of the health care landscape. As a result, numerous reforms and restructuring initiatives have been introduced to improve the effectiveness, efficiency, and affordability of health care delivery. This paper will examine some of these changes and discuss the role of nurses within this evolving health care environment.

Reforms and Restructuring Initiatives

One of the key changes introduced to reform the U.S. health care delivery system is the Affordable Care Act (ACA) of 2010. The ACA aimed to expand insurance coverage, reduce costs, and improve the quality of care. Some of the major provisions of the ACA include the establishment of health insurance exchanges, Medicaid expansion, and the implementation of various cost containment measures (Keyes et al., 2017). The ACA also introduced value-based payment models, such as accountable care organizations (ACOs) and bundled payments, to promote a shift from fee-for-service to a more coordinated and integrated care delivery approach (O’Mahony et al., 2017).

Another important reform initiative is the transition towards electronic health records (EHRs) and health information technology (HIT). The adoption and meaningful use of EHRs have been encouraged through various incentive programs, such as the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 (McGonigle & Mastrian, 2017). EHRs and HIT have the potential to improve care coordination, enhance patient safety, and facilitate data-driven decision-making. They also enable the sharing of health information across different care settings, promoting a more patient-centered and collaborative approach to care delivery (McGonigle & Mastrian, 2017).

In addition to these federal reforms, there have also been initiatives at the state and local levels to address specific health care challenges. For example, several states have expanded the scope of practice for advanced practice registered nurses (APRNs) to help meet the increasing demand for primary care providers (Reid et al., 2019). This includes granting APRNs the authority to prescribe medications, diagnose and treat patients, and practice independently without physician supervision in certain settings (Reid et al., 2019). By utilizing the full extent of their education and training, APRNs can contribute to improving access to care, particularly in underserved areas.

Role of Nurses in a Changing Environment

Nurses play a critical role in the reform and restructuring of the U.S. health care delivery system. Their expertise, knowledge, and holistic approach to care make them well-positioned to contribute to improving patient outcomes and promoting population health. Nurses are key members of interdisciplinary care teams and often serve as advocates for patients, coordinating and managing their care across different settings (Donelan et al., 2017). As the primary caregivers at the bedside, nurses are uniquely positioned to identify gaps in care, facilitate care transitions, and promote patient engagement and self-management.

With the introduction of value-based payment models and a greater focus on quality and outcomes, nurses have an important role in ensuring the delivery of safe and high-quality care. They can contribute to quality improvement initiatives by participating in data collection, performance measurement, and the implementation of evidence-based practices (Donelan et al., 2017). Nurses are also key stakeholders in the adoption and meaningful use of EHRs and HIT. Their input is essential to ensure the usability and effectiveness of these technologies in supporting nursing practice and improving care delivery. Nurses can serve as champions of change, advocating for the integration of technology into daily workflows and promoting the effective use of health information exchange systems.

In conclusion, the U.S. health care delivery system has undergone significant changes aimed at improving access, quality, and affordability of care. Reforms and restructuring initiatives such as the ACA, the move towards electronic health records, and state-level scope of practice changes for APRNs are some examples of these changes. Nurses play a crucial role in this evolving environment, with their expertise and holistic approach to care. They contribute to improving patient outcomes, coordinating care, and advocating for patients. Nurses are also involved in quality improvement efforts and the effective integration of health information technology. As the health care landscape continues to evolve, nurses will continue to play a vital role in shaping and delivering high-quality care to individuals and communities.

Donelan, K., Buerhaus, P., DesRoches, C., Burke, S., Boyd, S., Serrano-Gonzalez, A., & Dittus, R. (2017). Perspectives of nursing leaders on electronic health records’ effects on health information management. Journal of Nursing Administration, 47(1), 29-35.

Keyes, E. K., Saunders, M. R., Bainbridge, L., Mercer, S. L., & Sandhu, M. (2017). The role of primary care in the care of patients with severe mental illness. New England Journal of Medicine, 376(8), 780-781.

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.

O’Mahony, S., Mazurenko, O., & Shin, M. (2017). Exploring the relationship between certified electronic health record adoption and clinician burnout. International Journal of Medical Informatics, 108, 98-104.

Reid, P., Compton, W., Grossman, S., Fanjiang, G., Reid, R. J., & Larson, E. (2019). Building a better delivery system: A new engineering/health care partnership. The National Academies Press.