Cost effectiveness analysis (CEA) is a tool that can provide this evidence by evaluating both the costs and effectiveness of nursing interventions. Nurses, as health care providers, leaders, and advocates of high-quality, patient-centered, and cost effective health care ( Hart, 2012), will need to provide evidence of the value they provide. This shift has created an increasingly competitive environment. ACOs move beyond the expansion of health care insurance coverage to also include shift in payment incentives from volume (as seen in a fee-for-service model) to quality and outcomes ( Fisher, Bynum, & Skinner, 2009 Goroll & Schoenbaum, 2012 Sommers & Bindman, 2012). Department of Health and Human Services, 2011). The Patient Protection and Affordable Care Act (P-PACA) (2010) represents the latest national effort to improve quality and reduce health care costs.Ī key component of P-P ACA is the development of health care systems innovations, such as Accountable Care Organizations (ACOs), that aim to meet the P-PACA goal of ensuring accessible, high-quality, and affordable health care for all Americans ( U.S. Over the last 40 years managed care, as well as hospital and physician payment reforms, has come and gone without success ( Berenson & Rich, 2010). Many attempts have been made to mitigate health care costs while ensuring that the quality of patient care does not suffer in the process. health care has been a political issue for almost 40 years ( McMahon & Chopra, 2012).
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