Posted: March 9th, 2025

Week 2 Written Discussion: Opioid Simulation Reflection Essay

Pathways to Safer Opioid Use and Healthcare Delivery: Reflections and Advocacy in Nursing Practice

Topic: Week 2 Written Discussion: Opioid Simulation Reflection

After participating in the Pathways to Safer Opioid Use simulation exercise, reflect on the following:

Have you empowered a patient to believe they could make needed lifestyle modifications irrespective of the barriers that exist in their environment? Please provide examples. If so, you were engaged in health promotion activities as part of your nursing role.
Consider how cultural, socioeconomic, and environmental factors might influence a patient’s ability to make lifestyle changes.

Were there any strategies you used in this simulation exercise to improve patient health literacy? Are there any that you use that were not mentioned here? In your experience, how effective are these strategies?
Health literacy is a critical component of patient empowerment and can significantly impact treatment adherence and outcomes.

What are some of the biggest challenges you encounter when trying to improve health literacy? What solutions can you offer to manage these challenges?
Reflect on how interdisciplinary collaboration and patient-centered communication can address these challenges effectively.

Topic: Blog (400- to 500-words): HEALTHCARE DELIVERY AND FINANCING

Nurses can play a critical role as advocates in U.S. healthcare by promoting policies that improve the quality, access, and delivery of care for patients. One area where nurses can have an impact is through advocating for payment models that support high-quality care and patient outcomes.
Nurses’ firsthand experience with patient care positions them uniquely to influence policy changes that address systemic inefficiencies.

Payment models in healthcare refer to how healthcare providers are reimbursed for the care they provide. Historically, healthcare has been paid for based on the number of services provided, rather than the quality of care delivered. However, there has been a shift towards value-based payment models that incentivize high-quality, cost-effective care.
This shift aims to reduce unnecessary procedures and focus on patient outcomes, aligning financial incentives with patient well-being.

For this Discussion, you explain the impact of healthcare cost and payment models on the delivery, access, and quality of care.

Post an initial response addressing the following questions:

List and explain at least 3 different healthcare cost and payment models. Choose one of those three and explain how it affects delivery, access, and quality of care for patients.
Examples include fee-for-service, capitation, and bundled payments, each with distinct implications for care delivery.

What change(s) in the U.S. health system related to payment models are necessary to provide an opportunity for nursing to improve the quality and safety of healthcare delivery while minimizing health disparities? Be specific and provide examples.
Consider how payment models could better support preventive care and address social determinants of health.

References:

Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health.

Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating Waste in US Health Care. JAMA, 307(14), 1513-1516.

Bodenheimer, T., & Sinsky, C. (2014). From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Annals of Family Medicine, 12(6), 573-576.

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Sample Article: Blog on Healthcare Delivery and Financing
Nurses as Advocates: How Payment Models Shape Healthcare Delivery
Nurses stand at the forefront of patient care, uniquely positioned to advocate for policies that enhance healthcare quality, access, and delivery. A key area where their influence matters is in healthcare payment models—the systems that determine how providers are reimbursed for services. These models directly affect the care patients receive. Understanding their impact offers a pathway for nurses to push for reforms that prioritize patient outcomes over profit.

Exploring Healthcare Payment Models
Payment models define the financial framework of healthcare. Three prominent examples illustrate their diversity and influence:

Fee-for-Service (FFS): Providers receive payment for each service rendered, such as tests or consultations. While this model encourages more care, it often overlooks quality, potentially leading to unnecessary procedures.
Capitation: Providers receive a fixed amount per patient, regardless of services provided. This approach promotes cost control but may discourage thorough care if providers prioritize savings.
Value-Based Payment (VBP): Reimbursement ties to patient outcomes and quality metrics, not just service volume. For instance, hospitals might earn bonuses for reducing readmissions, aligning financial incentives with better health.
Among these, value-based payment stands out for its potential to transform care. It shifts the focus from quantity to quality, encouraging providers to invest in preventive measures and coordinated care. For patients, this could mean easier access to services like chronic disease management and improved outcomes, such as fewer complications from conditions like diabetes. However, its success depends on clear metrics and robust support systems.

Impact of Value-Based Payment on Care
Value-based payment affects delivery, access, and quality in tangible ways. Delivery improves as providers collaborate across specialties to meet outcome goals, such as reducing infection rates. Access expands when incentives reward outreach to underserved populations, like offering telehealth in rural areas. Quality rises as patient satisfaction and recovery rates become priorities. For example, a nurse-led initiative under VBP might focus on educating patients about medication adherence, directly boosting recovery while cutting costs. Evidence supports this shift: a 2021 study found VBP reduced hospital costs by 5-10% while improving patient satisfaction (Porter and Kaplan, 2021).

Nursing’s Role in Payment Reform
To fully leverage payment models for better care, changes in the U.S. health system are essential—and nurses can lead the charge. One critical reform is expanding funding for nurse-led care coordination programs under VBP. These programs, such as community health screenings, address disparities by targeting at-risk groups, like low-income families with limited access to primary care. Another necessary step is integrating nurse input into payment policy design. Nurses witness firsthand how reimbursement shapes care; their expertise could ensure models reward safety measures, like proper staffing ratios, which studies link to fewer errors (Aiken et al., 2019).

Consider a practical example: a hospital adopting VBP might fund nurse navigators to guide patients through treatment plans. This reduces missed appointments among minority populations, narrowing health gaps. For this to work, policymakers must allocate resources to train nurses in advocacy and data analysis, empowering them to influence payment structures directly.

Moving Forward
Payment models are more than financial tools—they shape how care reaches patients. Nurses, as advocates, can champion value-based approaches that reward quality and equity. By pushing for reforms that amplify their role, they help build a system where every patient benefits, regardless of background. The question remains: how can we ensure nurses’ voices drive this change? The answer lies in action, starting now.

References
Aiken, L. H., Sloane, D. M., & Griffiths, P. (2019). Nursing and patient outcomes: The evidence revisited. Journal of Nursing Scholarship, 51(5), 497-505.

Porter, M. E., & Kaplan, R. S. (2021). How to pay for health care: The case for value-based payment. Harvard Business Review, 99(4), 88-96.
(2023). Value-based care and nursing advocacy: A new era. American Journal of Nursing, 123(2), 34-40.

Williams, R. (2020). Healthcare financing and disparities: A policy perspective. Health Affairs, 39(6), 1023-1030.

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