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Assignment – (At least 500-600 words each part, and independent of each other). Discuss each part using current sources (2015-2020) only and additional resource readings to: PART A – ACA Reflect on whether you oppose or support the Affordable Care Act (ACA). Consider the nursing professional’s position as a caregiver and/or the healthcare leader as an administrator. Explore two significant components of the ACA that could potentially impact specific populations unjustly. Appraise the current political climate as it relates to repealing and replacing the ACA. For this weeks’ discussion, identify at least two reasons for keeping the ACA and at least two reasons that it should be repealed, replaced, or revised. Provide rationale for each. Henry J. Kaiser Family Foundation (2018). Retrieved from http://files.kff.org/attachment//fact-sheet-key-facts-about-the-uninsured-population Additional Resources: Garfield, R. (2016, October 19). The coverage gap: Uninsured poor adults in states that do not expand Medicaid. Kaiser Family Foundation.  Why Do We Need the Affordable Care Act? American Public Health Association. Seo, V., Baggett, T. P., Thorndike, A. N., Hull, P., Hsu, J., Newhouse, J. P., & Fung, V. (2019). Access to care among Medicaid and uninsured patients in community health centers after the Affordable Care Act. BMC Health Services Research, 19(1), N.PAG. Vaughan Prengaman, M., Welle, D. L., Ridenour, N., & Mueller, K. J. (2018). Diverse stakeholder perspectives on rural health care reform in a U.S. state that rejected the Affordable Care Act: A case study. Online Journal of Rural Nursing & Health Care, 18(2), 65–87.  Wasserman, J., Palmer, R. C., Gomez, M. M., Berzon, R., Ibrahim, S. A., & Ayanian, J. Z. (2019). Advancing health services research to eliminate health care disparities. American Journal of Public Health, 109, S64–S69.  PART B: Leading a change Reflecting on what you have learned about the social determinants of health, SDOH, how can nurses work collaboratively with physicians and other health care professionals to improve primary care, reduce overutilization and improve underutilization of healthcare services? Include in your response how fostering an environment of diversity and cultural awareness among healthcare providers builds a stronger healthcare team and improves care delivery to healthcare consumers. Resources: Fraze, T. K., Beidler, L. B., Briggs, A. & Colla, C. H. (2019). ACOs commonly use home visits for complex patients during care transitions. HealthyPeople.gov (2019). Healthy people 20/20 evidence-based resources. HealthyPeople.gov (2019). Social determinants of health. Manchanda, R. (n.d) “What is an upstreamist in care?” PART C: Quality of Healthcare The Joint Commission determines the highest priority patient safety issues and how best to address them, including as a National Patient Safety Goal (NPSG). Access the Joint Commission website for the most current NPSGs. Select one or more NPSGs and address the following: Explain the rationale for applying the NPSG in nursing practice. Discuss some of the benefits and/or challenges of implementing the NPSG in a health care organization? How does appropriate application of the elements of performance in the NPSG reduce negative patient outcomes? Resources Agency for Healthcare Research and Quality (n.d.). Patient safety and quality improvement. The Joint Commission (2019). 2019 National patient safety goals (NPSG). National Database of Nursing Quality Indicators(n.d.). NDNQI nursing-sensitive indicators. National Quality Forum (n.d). Improving access to high-quality car for individuals with serious mental illness. Register on the IHI website. It is a free resource. Read the White Papers found on the Institute for Health (IHI) website: Martin, L. A., Neumann, C. W., Mountford, J., Bisognano, M., & Nolan, T. W. (2009). Increasing efficiency and enhancing value in health care: Ways to achieve savings in operating costs per year. Stiefel, M. & Nolan, K. A (2012).  A guide to measuring the triple aim: population health, experience of care, and per capita cost. 

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