In the recent past, the United States healthcare system has undergone sporadic changes aimed at reforming and restructuring it. These changes have been majorly driven by the Affordable Care Act (ACA) OF 2010. Various regulations have been introduced in this law, and several standards aim to improve access to healthcare, reduce healthcare costs, and improve the quality of care. Nurses have therefore been tasked or presented with new roles and responsibilities, which are vital in prompt response to the changes that the act has brought about. This paper seeks to examine the various changes that have been introduced to reform and restructure healthcare in the U.S healthcare delivery system, discuss the impacts of these changes on nursing practice and the role of nurses in implementing these changes, discuss nursing professional leadership and management roles and also give a prediction of two ways in which nursing practice and nursing roles will grow and transform within the next five years in response to upcoming trends and predicted issues in healthcare.

Current or Emerging Health Care Law or Federal Regulation

One of the most significant reforms and changes in the U.S. healthcare system in the past years is the introduction of the Affordable Care Act (ACA) of 2010. This law was formed with the central aim of reforming and restructuring the healthcare system through expanding the number of people covered by insurance, healthcare quality improvement, and healthcare cost reduction. Specifically, the introduction of ACA has led to the adoption of various rules, regulations, and standards for quality healthcare delivery. This has also included establishing changes in health insurance, Medicaid eligibility expansion, reintroduction of quality measures, and pay-for-performance initiatives. This act has also enabled the establishment of various health insurance marketplaces. It established a federal and state health insurance marketplace known as exchanges that would make it easier for families and individuals to be in a better position to compare and purchase health insurance plans with an informed decision. Moreover, the act has helped in the prohibition of discriminatory acts based on some preexisting conditions; this means that ACA has illegalized denial of coverage by health insurance companies or the insurance companies charging higher payments in the form of premiums as a result of existing medical conditions.

Effect of the Affordable Care Act on Nursing Practice and the Nurse’s Role

The adoption and implementation of the ACA have significantly impacted the nursing practice and nurses’ roles. A good example is the increment t of affordable healthcare access through expanding Medicaid eligibility. This has also been achieved by establishing various health insurance exchanges (Cleveland & Smith, 2019). The significant result of this has been increased demand for nursing services. Therefore, most nurses are expected to continuously provide proper comprehensive care to many patients who need it (Cleveland & Smith, 2019).

Moreover, ACA has also introduced various measures to ensure quality care and reward by paying for incentives due to good performance. This has had a ripple effect in the form of increasing care attention to the patients and ensuring that the outcomes of service provision of the patients are exemplary (Cleveland & Smith, 2019). Finally, nurses are also required by ACA to take up new responsibilities and roles that would make them continuously provide the best services to the patients. These roles and responsibilities include preventing diseases, educating patients, and promoting healthcare.

Quality Measures and Pay for Performance

ACA has introduced quality measures and payment for performance incentives to help in improving patient quality care. Quality measures have been known as the metrics used to evaluate the quality of care patients provide (James, 2018). These include readmission rates, satisfaction scores of the patients, and mortality rates. Pay for performance incentives, on the other hand, are the financial rewards that healthcare providers receive as a result of attaining or meeting the measures of quality (James, 2018). Patient outcomes have significantly been impacted by the quality measures and pay for performance since these measures lead to a proliferation of focus on evidence-based and the best patient–centered care.

Professional Nursing Leadership and Management Roles

As a result of ACA, various nursing roles have also emerged, such as management and leadership roles. For a proper response to the ever-dynamic healthcare environment, nurses must be aggressive in taking continuous learning of management and leadership courses to ensure patients are provided with the