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Summary: The Healthcare Hierarchy

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As referenced above, the healthcare hierarchy must change to be effective in an ACO. As stated by Korda and Eldridge (2011), the structure of healthcare will need to change to a “‘flatter’ management structure that can lead to shared decision making and co-management of patient care.” The co-management of patient care is certainly a change in the current healthcare delivery system and nurses will be required to become leaders and advocates for both nurses and patients. Under ACOs, nurses will become more responsible for outcomes achieved or not achieved at the bedside, which will lead to nurses being responsible for the financial aspects of a healthcare organization (Korda & Eldridge, 2011). Nurses responsible for the financial success and …show more content…

It is possibly the nurses with the experience may have the opportunity to have new ventures as “nurse-led care coordination firms,” allowing for further autonomy (American Nurses Association, 2010). Other new potential roles include patient collaborator, quality measurement specialist, performance improvement specialist, and a “voice” for the management of chronic illness and disability (Korda & Eldridge, 2011). Caution should be taken by nurses stepping into more advanced roles in care coordination that compensation is appropriate, as this is a concern under the new model (McMenamin, n.d.). Nurse managers will need to be advocates for nurses taking on increased responsibility and integration of healthcare …show more content…

One concern of the adoption of the ACO is that nurses may spend increased time documenting outcomes and data to meet incentives and less time providing direct patient care (McMenamin, n.d.). Also, nurses are not directly referenced in legislation for ACOs and are considered “other healthcare professionals,” leaving the verbiage of the nurse role up for interpretation (American Nurses Association, 2010). In addition, certified nurse midwives and certified registered nurse anesthetists are “not considered in the final rule” but nurse practitioners are defined (American Nurses Association, 2010). Further clarification will be required for advanced nurses to practice

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