Why Nurse Managed Health Clinics Are the Future of Health Care
When the Patient Protection and Affordability Act goes into effect in 2014, almost overnight an additional 31 million Americans will have health care coverage. It stands to reason that there will be increased demand for health care services, especially given that the number of individuals with chronic conditions, including type 2 diabetes, hypertension and high cholesterol, is also expected to increase.
The problem? At the present time, there simply are not enough doctors to meet the expected demand. By some estimates, within the next decade there will be a shortage of at least 35,000 general practice physicians in the U.S. As a result, health care reform efforts have focused significant attention on the need for additional practitioners to handle the expected increase in demand for services. One of the many proposed solutions is to increase the number of nurse managed health clinics.
Quality Care, Affordable Prices
Currently in the U.S. there are approximately 250 nurse-managed health clinics. These clinics, often located in traditionally underserved areas like inner cities, provide basic medical services to patients who may not be able to afford care at hospitals or doctor’s offices. These clinics offer care for minor ailments — a child’s ear infection, for example — as well as preventive care and management of chronic conditions like diabetes or asthma. Some of these clinics also offer dental and mental health services as well as educational services, such as parenting preparation.
But unlike a hospital or traditional medical practice, the services at these clinics are provided entirely by advanced practice nurses. These nurses have a higher level of training and experience as well as the ability to prescribe medications, making them a viable alternative to doctors. In terms of cost, many patients see significant savings by visiting a nurse-managed clinic rather than their doctor or urgent care facility, as co-payments and out-of-pocket fees for these clinics tend to be lower than those of other providers.
At the same time, overall health care costs tend to decrease as a result of patients having access to these clinics. Patients have better relationships with their providers, higher rates of compliance with care instructions and better outcomes when they have access to affordable care — and when the outcomes improve, costs go down. Not to mention, communities with nurse-managed health clinics tend to have lower emergency room utilization rates, which is important when you consider that emergency-room costs for low-income patients represent a significant portion of overall health care costs in the U.S.
Affordable Care Act and Nurse-Managed Clinics
One of the provisions of the Affordable Care Act of 2010 is the earmarking of at least $50 million per year through 2014 — and perhaps beyond — for the development of new nurse-managed health clinics. These clinics must be led by advanced practice nurses and be associated with an independent health or social services agency, university, college or school of nursing, or be a federally qualified health center. By opening new clinics in medically underserved communities, where access to care may be limited by a shortage of doctors, distance to facilities, cost or other factors, lawmakers hope to ensure that all Americans have access to the care they need.
Yet despite the availability of money to establish the clinics, there are still barriers that need to be overcome, most notably a shortage of qualified nurses to manage the clinics. According to the American Association of Colleges of Nursing, nearly 80,000 qualified nursing school applicants were turned away from programs in 2012 because of the lack of appropriate training sites. Given that 99 percent of all existing nurse-managed health clinics serve as training sites for nurses as well as social workers, pharmacists and other practitioners, increasing the number of available clinics will not only improve access to health care, but it will also aid in qualifying nurses to meet the increasing demand for health care.
The Affordable Care Act also includes provisions to increase funding to nurses who want to advance their education, such as earning an RN to BSN online (go right here for more information on your options) or a nurse practitioner designation. The ACA offers nurses grants and loan forgiveness programs in exchange for agreeing to work in underserved areas — specifically, areas served by nurse-managed health clinics, making it more affordable for professionals to improve their education and career prospects.
The health care landscape of the next few years remains uncharted territory. But for nurses, the development of additional nurse-managed health clinics represents a great deal of opportunity – and the future of health care delivery in the U.S.
About the Author: Nina Solter is a registered nurse who left patient practice to serve as a health care analyst for a regional task force charged with developing new care delivery models for underserved patients in the rural Midwest.
Category: Career
