Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment. Include the following: Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.

 Healthcare Delivery Models and Nursing Practice
Changes Introduced to Reform and Restructure the U.S. Healthcare Delivery System
Like education, healthcare also need to be given importance. Healthcare delivery structures are the most visible purpose of the health system to patients and the public. It focuses on patient flow as well as the organization and delivery of all services trafficking with the diagnosis and treatment of a disorder or the promotion, maintenance and restoration of health (Johnson et al., 2020). The World Health Organization considers health service delivery suitable when equitable access to a comprehensive range of high-quality health services is ensured within an integrated and person-centered continuum of care. The aim of the implementation of models of care is to achieve a stable between improving consumer outcomes and ensuring efficient and effective use of specialist mental health resources. This essay will discuss the current healthcare law, quality measures and pay of performance effect on patient outcomes, and finally, look at the roles of professional nursing leadership and management.

Current Healthcare Law or Federal Regulation
A current healthcare law reforming healthcare in the United States is the sustaining excellence in Medicaid act of 2019. The act was introduced to the public on June 13, 2020, signed into law on August 6, 2020, and was introduced and sponsored by the Michigan representative and Debbie Dingell (Heisler et al., 2019). This act aims to restructure the Medicaid program by providing some extensions in some of the provisions. One of the developed changes was allowing the appropriations of Medicaid through the fiscal year 2024. The Medicaid act also allowed the state fraud units within the program to consider and examine complaints from the non-institutionalized patient. The reform is essential because it eliminates some of the disparities that arise from ignoring the complaints from such patients that qualify for coverage under the Medicaid program. The act also introduced another reform, extending the Medicaid eligibility for individuals to protect them from spousal impoverishment or poverty. Most spouses from lower socioeconomic backgrounds are denied coverage, explaining that Medicaid does not extend to them. The act extends cover to such communities and to those who receive home-based and community-based medical services. The bill affects the nursing practice through adjusting the nurse’s role and responsibility (Nsiah et al., 2019). This can be seen as the bill extends Medicaid to cover the spouses and protect them from impoverishment, and the nurse should ensure that they educate all patients about the new changes to this bill. Patients suffering from spousal poverty may limit their access to quality medical care. The nurse should be able to identify such patients and educate them about the current changes that may help them access quality medical care. The bill also affects the nurse’s role and responsibility as it adds to the role of advocacy in nursing. The nurse is responsible for advocating for non-institutionalized patients whenever they have complaints and helps them appeal to Medicaid in case of denial of services. The nurse should advocate and help patients access social justice by helping them branch complaints.

Effects of Quality Measures and Pay of Performance on Patient Outcomes
Pay for performance is a reward system that rewards practitioners financially for their performance based on specific criteria in medical practice. Pay for performance is a performance-based compensation approach aiming to improve the quality and delivery of healthcare services to patients (Aghajani et al., 2021). This model punishes the practitioners for achieving poor results. It can be seen when a psychologist whose patient fails to quit smoking at the end of their sessions they do not receive the financial rewards associated with their role. This model, in some ways, improves patient outcomes as it motivates healthcare providers to offer high-quality services to their patients, ensuring they receive the financial rewards associated with their roles and criteria used for performance analysis. This reward system is also associated with a risk of poor patient outcomes, where it encourages patient dumping. Patients with more complicated healthcare issues are high risk and tend to be relegated to the periphery. The healthcare providers prefer focusing on cases that are likely to be successful so that they may receive rewards and bonuses (Kyeremateng et al., 2019). Nurses who find themselves in such situations should consider applying ethical principles such as non-maleficence, which means causing the least harm. Applying this principle, the nurse can encourage the physicians to admit and attend to patients with complex medical issues.

Professional Nursing Leadership and Management Roles
An emerging nursing leadership role addressing emerging trends would be knowledge of nursing informatics and the use of technology in nursing. An emerging trend in healthcare is using technology in the practices, increasingly requiring nurses to learn and equip themselves with technology and skills (Archibald & Barnard, 2018). This can be seen as there are surgical robots used in surgery, and surgical nurses should be conversant with the machines so that their role in the surgical room is fulfilling. It can also be seen from the use of bedside alert systems notifying the practitioners when patients leave their beds unattended, reducing patient fall incidences. Nurse leaders are responsible for ensuring that the nursing teams are technologically savvy as part of their nursing roles (Ronquillo et al., 2021). Nurse leaders and managers have to ensure the availability of technical training to enhance the nursing team’s professionalism; by doing so, nurses promote patient health and safety. The bedside alert systems reduce the incidence of patient falls, and learning how to manage the electronic health records promotes patient health and enhances their professionalism levels since they comply with the HIPPA rules.

Conclusion
Healthcare delivery structures are visible function of the health system, both to patients and the general public, and it focuses on patient flow as well as the organization and delivery of all trafficking dealing with the diagnosis and treatment of a disorder or the promotion, maintenance and restoration of health. The sustaining excellence in Medicaid act of 2019 is a current federal law reforming healthcare in the United States which was introduced by the Michigan representative and Debbie Dingell. Pay for performance is a reward system that rewards practitioners financially for their performance based on specific medical practice criteria. It is a performance-based compensation approach aiming to improve the quality and provision of healthcare services to patients. An emerging trend in healthcare is the use of technology in the practices, which are increasingly requiring nurses to learn and equip themselves with technology and skills.