Nurse-managed care organizations are groups of healthcare professionals working together to provide quality and affordable healthcare services. The organizations consist of physicians, specialists, and hospitals that provide care for a specific monthly fee. Managed care organizations control patients’ access to doctors, specialists, laboratories, and treatment facilities as measures to control and manage the ever-rising medication costs (Enthoven et al., 2019). Some healthcare specialists charge high prices for their services requiring patients to pay huge sums of money; however, managed care organizations inform the patients of the alternative and cheaper care methods they can use to obtain similar results.

Nurses play massive roles in ensuring that patients and their families receive the best and most affordable healthcare services. The high cost of healthcare often makes many families and patients avoid coming to healthcare facilities because they lack information about healthcare and healthcare costs (Austin & Wetle, 2018). Consequently, nurses, such as resource persons and care managers, help patients receive quality and patient-centered healthcare at relatively low costs. The action by nurses in the above roles results in managed care to help control the ever-increasing costs of healthcare (Mason et al., 2018). As a result, managed care organizations significantly manage and reduce the cost of healthcare in the community, unlike health insurance plans, which cannot pay for routine health services.

In conclusion, the need for change and benefits for nurse-managed health centers and clinics is to help patients receive quality healthcare services and affordable costs. However, the health centers face a lack of support from the health care stakeholders; therefore, it is high time the government and the Department of Health and Human Services support the centers because they significantly contribute to the betterment of health care in the country.

References

Austin, A., & Wetle, V. (2018). The United States Health Care System: Combining Business, Health, and Delivery (3rd ed.). Pearson Education, Inc.

Enthoven, A., Fuchs, V. R., & Shortell, S. M. (2019). To control costs, expand managed care, and managed competition. JAMA, 322(21), 2075. https://doi.org/10.1001/jama.2019.17147Links to an external site.

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2018). Policy & Politics in Nursing and Health Care (7th ed.). Elsevier.

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Kathy Ascencio
Apr 7 3:45pm
| Last reply Apr 12 9:35pm

Reply from Kathy Ascencio

Nurse-Managed Health Centers and Clinics

Nurse-managed health centers (NMHCs) are community-based clinics run by advanced practice registered nurses (APRNs), especially nurse practitioners. These centers offer primary care, health education, disease prevention, and chronic disease management, often in underserved or rural areas. They emphasize holistic, patient-centered care that is accessible and affordable.

Why the Change to Nurse-Managed Health Centers and Clinics is Needed
NMHCs are needed because many communities lack access to regular healthcare due to physician shortages, cost barriers, or transportation issues. The growing demand for primary care services, combined with a limited supply of providers, has made NMHCs a necessary solution. The Affordable Care Act and healthcare reform efforts highlighted the need for cost-effective care models, which NMHCs fulfill.

Benefits of Nurse-Managed Health Centers and Clinics
These clinics improve access to care, reduce emergency room visits, and provide comprehensive, continuous care. They are often located in schools, public housing, or rural settings, making care more convenient. NMHCs also lower healthcare costs and focus on prevention and education, leading to better health outcomes and patient satisfaction.

Solutions to Obstacles for Nurse-Managed Health Centers and Clinics
Common obstacles include limited funding, staffing shortages, and restrictive state regulations. Solutions include expanding federal and state funding, integrating NMHCs into Medicaid and Medicare reimbursement models, and offering loan repayment or incentive programs to attract nurse practitioners. Regulatory reform to allow full practice authority for APRNs can also increase the reach of these clinics.

References
Health Resources and Services Administration (HRSA). (2022). Shortage Areas. https://data.hrsa.gov/topics/health-workforce/shortage-areas
Mason, D., Dickson, E.L., Perez, G.A., & McLemore, M. (Eds.). (2021). Policy & politics in nursing and healthcare (8th ed.). Elsevier.

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Tammy Anderson (She/Her)
Feb 18 8:16am

Reply from Tammy Anderson
You’ve all identifying the importance of nurse-managed health centers in expanding access to care. As you continue the discussion, think about how these centers can adapt to meet growing healthcare needs while overcoming challenges like funding and staffing. Consider innovative strategies that could enhance their sustainability and effectiveness, and explore the long-term impact of these centers on patient outcomes and community health.

I’m looking forward to seeing your ideas!

Dr. Anderson

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