Experts clarify roles of healthcare professionals under the ACA


(From left) Pamela Cipriano, Ardis Hoven, Lucille Beseler, Joan Bardsley, and Jonathan Marquess answer questions from the audience during Thursday’s Meet the Experts session.

The Affordable Care Act (ACA) has support from AADE and several other professional organizations, but work remains to make it work better for diabetes educators, physicians, nurses, dietitians, and pharmacists. Each of those groups was represented in a discussion of the ACA Thursday.

“There are opportunities and threats in any change. I see great opportunities for diabetes educators [under the ACA],” said AADE President Joan Bardsley, MBA, RN, CDE, FAADE, at the start of the Meet the Experts Debate, “Affordable Care Act: Opportunities and Obstacles.” “If we are aware of the opportunities out there, it is up to us to lead to the desired outcomes.

“The threat is the unwillingness to take charge of what we need to do as ourselves and our profession. This is a stage we need to set; we need to be the drivers, and we need to be the leaders.”

Ardis Hoven, MD, immediate past president of the American Medical Association (AMA), reinforced the AMA’s support of the ACA, and discussed the law’s impact, saying it improves health care delivery and efficiency. She also said it is driving a change to a team-based approach to health care that focuses on prevention.

“Collaborative care is the wave of the future,” Dr. Hoven said. “When you tackle a disease as complex as diabetes, it is impossible to do it alone. It requires continuity of care. We all have our roles to play to accomplish something we could not do by ourselves.”

Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA), agreed with Dr. Hoven that collaboration among healthcare professionals is key. The various professional groups have overlapping roles, but also have specific roles in education and healthcare teams.

“Care coordination is a competency of nurses. It is an area where nurses excel,” Dr. Cipriano said. “It is important to work together. We have to continue policy discussions. We have to be leaders influencing lawmakers. The ANA is pledged to work together, and we look forward to continuing the dialog.”

Lucille Beseler, MS, RDN, president of the Family Nutrition Center of South Florida, represented the Academy of Nutrition and Dietetics. A foundation of the ACA is preventive care, and a healthy diet is a key in developing a healthier public, she said.

“When you talk about prevention, who does not think of RDNs [registered dietitian nutritionists] and nutrition. The ACA has had an impact with increased access to RDNs,” Beseler said, but added that it is discouraging that RDNs are not among the professionals listed as part of healthcare teams in accountable care organizations.

Jonathan Marquess, PharmD, CDE, CPT, vice president of professional and clinical affairs for the American Pharmacy Cooperative, Inc., and representing the American Pharmacists Association, discussed the key role pharmacists play in the open enrollment periods for the ACA.

“We played an integral role in open enrollment, and will be ready for questions in November, during the next open enrollment period,” Dr. Marquess said. “Pharmacists are underutilized providers who are willing to assist.”

The five experts then formed a panel in which they answered questions submitted by AADE members before the Annual Meeting, and from audience members, about the ACA. Among the topics discussed were the importance of quality measures, competitive bidding on supplies for patients with diabetes, workforce issues, and the roles of nurse practitioners, registered nurses, and certified diabetes educators in accountable care organizations.

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