Reply 1It is indeed a fact that the nurse-managed health centers and clinics (NMHCs) have worked to provide patient care at more convenient locations. Throughout the country, there are 250 NMHCs recordings more than 2.5 million patients annually with a capacity to serve millions more. They are located primarily in medically underserved locations including low-income urban neighborhoods and rural areas. These centers are critically important as safety net providers of care for the medically underserved. They have a reputation for providing high-quality, cost-effective care and achieving high patient satisfaction rates. Nurse-led care is significantly low in cost than physicians or an urgent care facility. NMHCs are cost-effective. The NMHC majors on wellness promotion, disease prevention, and management of chronic conditions including asthma, hypertension, and diabetes. They also provide dental, behavioral health; health education; environmental health risk reduction; and parenting education services which is a good for the healthcare system (Hansen-Turton, Bailey, Torres, & Ritter, 2010).NMHCs serve the patients least likely to receive ongoing health care services including uninsured, underinsured, or patients living in poverty who are unable to pay for care and thus charged on a sliding scale or treated for free. The main challenge for NMHCs is money problems as they struggle to achieve fiscal sustainability. They serve poor communities and depend on Medicaid and Medicare reimbursement, private grants, and government contracts and grants. Most are operated by schools of nursing, and some of these receive financial assistance from their parent organizations but this limits their federal funding availability. Because many NMHCs are unable to access the financial resources available to other safety net providers, many are struggling to care for uninsured, and vulnerable in the community. Solutions including policy framework to increase federal and state funding, stop the discriminatory reimbursement discriminating against NPs acting as primary care providers (Hansen-Turton, Bailey, Torres, & Ritter, 2010).Reply 2There is a need for change from nurse-managed health centers and clinics due to the evolving health care systems and patient needs. The transformational practice is required to provide patient-centered care services at a lower cost and meets the increasing demand for care from an increasing population. The challenges that come with transforming practice include the shortages of primary care providers and insufficient resources (Auerbach ET AL., 2013). To address these problems that affect change including the integration of liberalized policies, increased training, facilitating payment changes and rewards, and increasing the number of licensed practicing nurses and aides.

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