The objectives of the Home Health Care Planning Improvement Act (HHCPIA) of 2011 target nurses, clients, and the health care system as a whole. The implications for nursing would include improving autonomy for advanced practice registered nurses (APRNs) through increased decision-making authority in the home health setting. Currently, APRNs are required to receive physician approval for home health treatment plans (Sullivan, 2010). Client benefits would include increased availability of healthcare providers, especially in rural areas where access to physicians is limited. The act would also ensure Medicare coverage for clients receiving home health care from APRNs. This legislation would also eliminate unnecessary waiting periods for care.
The American Nurses Association supports this bill because of the autonomy for APRNs granted by the bill. It would also expand the availability of health care resources to individuals. Supporters include the American Academy of Physician Assistants, American College of Nurse Practitioners, American College of Nurse Midwives, American Academy of Nurse Practitioners, and Visiting Nurse Association of America (Mullin, 2011). It is speculated that the Federal Physicians Association would oppose the legislation because it would detract financially from physicians’ practices. However, it could be supported because the amount of paperwork for primary care physicians would be reduced due to the involvement of APRNs. Taxpayers would have influence on this bill because their tax money would go towards funding Medicare. It is possible that an increase in taxes will be necessary to support the increased resources being used on a wider population. The American Association of Retired Persons supports the HHCPIA. The HHCPIA is supported by eight Democrats and one Republican in the Senate, and thirty-one Democrats and fifteen Republicans in the House of Representatives.
The implications of the Home Health Care Planning Improvement Act will have implications for nurses, the patients, and the health care system. The impacts on nursing include increased demand for nurse practitioners in under-resourced areas and increased autonomy. There is a possibility for more paperwork and a bigger workload. It could enhance the nurses’ ability to be an advocate for their patient. The patients will save time, money, and effort by reducing travel time necessary for health care at primary physician offices. There is also increased autonomy of the patients in health care decisions and an increased chance of survival related proximity to health care services.
The health care system will experience an expanded role of APRNs and PAs. The bill could save money for Medicare in relation to the decreased requirement for long-term health care (Mullin, 2011). The bill will require a re-evaluation of the perception of the nurse as a handmaid to the doctor. Studies by Dobson DaVanzo and Associates have found major savings for the Health Care System (Conant, 2011):
Savings Estimate |
Cumulated Estimated Medicare Savings |
1-Year Estimate (2011) | $6.3 million |
5-Year Estimate (2011-2015) | $80.4 million |
10-Year Estimate (2011-2020) | $273.1 million |
Alternate Model: 10-Year Estimate with no change in proportion of certification/recertifications to Medicare claims
For more information: | $124.3 million |
Conant, R. (2011). Headlines from the hill: home health care planning act of 2011. American Nurse Today, 6(5), 20. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/AmericanNurseToday/Archive/2011-American-Nurse-Today/May11-ANT/Headlines-from-the-Hill-May11.aspx
Mullin, E. (2011, June 28). Bill would expand home health referral powers to nps, pas. Dorland Health, Retrieved from http://www.dorlandhealth.com/case_management/clinical/Bill-Would-Expand-Home-Health-Referral-Powers-to-NPs-PAs_1838.html
Sullivan, T. (2010, September 20). Home health care planning improvement act of 2010. Retrieved fromhttp://www.policymed.com/2010/09/home-health-care-planning-improvement-act-of-2010.html
I think that the Home Health Care Planning and Improvement Act is another major bill that supports the objectives of Obama's Affordable Healthcare Act. The limited availability of physicians in many areas will, I imagine, predispose the physicians that are available to taking on the PCP role, further limiting the number of circulating physicians providing home health care. Allowing APRNs to practice as full care providers without adding the speedbump of contacting physicians to get paperwork signed should help to streamline the process of providing care, which will further allow that same number of APRNs the time to help even more patients. I'm surprised that APRNs are limited like this, because nurses are superb teachers, and I'm sure that most patients in home care settings could benefit from having greater access to the client teaching that a nurse can provide. Countless studies have correlated the link between patient teaching and improved health outcomes, so it's about time that the teaching health care provider has more access to in-home care.
ReplyDeleteHealth care workers currently face the growing challenge of providing quality level care to a growing population. Combining this factor with many health care professionals' desire to enter acute care settings rather than home health, certain populations will be unable to receive adequate care, if any at all. The role of APRNs is drastically changing from that of secondary provider to primary provider. Allowing them to bypass the obstacle of paperwork required to provide care would expand the availability of care to disadvantaged populations. I agree with Jon's comment above; the fact that nursing teachers hold the responsibility to educate FUTURE health care workers should be evidence enough to support the passing of this bill.
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