Enhancing Nurse Awareness of Healthcare Financing- Communication Protocols and Educational Initiatives
Reimbursement & Financing Issues
In order to meet the escalating demand for healthcare and achieve universal healthcare, significant changes in healthcare reimbursement are taking place. In order to address issues of reimbursement, several national policies have been established. This method has led to the adoption of initiative-based performance and value-based reimbursement by the majority of healthcare organizations, with the Affordable Care Act serving as a shining example. The move from the fee-for-service model to the new healthcare remuneration system is toward a more value-based, outcome-oriented one (Counte et al., 2018). The development of Accountable Treatment Organizations (ACOs), whose goal is to increase treatment quality while lowering costs, represents a parallel change in how healthcare is paid for. Depending on the ACO, care reimbursement may be constant, variable at first, or variable on a monthly basis (Bowling et al., 2018). At my company, decisions are being made to adjust to the new reimbursement scheme. It’s crucial to involve the nursing staff in major organizational decisions. Shared governance is one of the ways the business is putting this change into action. A framework for nurses to engage in organizational decision-making is provided through shared governance (French-Bravo & Crow, 2015).
New reimbursement rules have been introduced with greater accountability and nurse input as a result of nurses’ participation in shared governance. Notably, shared governance has improved nurses’ understanding of the organization’s financial goals. All parties are more likely to be on the same page if their financial objectives have been clearly expressed.
In addition, as part of the development of team-based care, the nursing staff is being informed about changes to reimbursement. The team-based care model places the nursing staff at the center of healthcare reimbursement to ensure that nurses deliver comprehensive and cost-effective care. As a result, buy-ins are developed as an additional strategy for informing the nursing staff of new healthcare reimbursement rules. First, it’s important to inform the nursing staff of the upcoming change and motivate them to take immediate action. It is the responsibility of nursing leaders, who command significant influence among their colleagues, to inform their teams of these trends. The nurses’ opinions are then solicited to ensure that the finished alterations are the outcome of mutual discourse. According to French-Bravo & Crow (2015), nursing managers should assess both their staff members’ “emotional buy-in” and “intellectual buy-in” to the project at hand.
There are several ways to improve nurses’ comprehension of the difficulties with healthcare funding. It is crucial to start training and educating nurses in institutions. The knowledge and basic financial management skills nurses would learn from this program will help them better understand the financial elements of healthcare.
In order to provide patients with high-quality, reasonably priced treatment, nurses should be encouraged to promote quality improvement. The promotion of innovative solutions that honor nurses for their great contributions to responsible financial management is essential to reducing the overall cost of healthcare. Additionally, it’s critical to emphasize healthcare budgeting that functions and gives nurses the power to make financial decisions. Nurses would thus be encouraged to stick to their budgets in order to prevent deficits.
References
Bowling, B., Newman, D., White, C., Wood, A., & Coustasse, A. (2018). Provider reimbursement following the Affordable Care Act. The health care manager, 37(2), 129–135.
County, M. A., Howard, S. W., Chang, L., & Aaronson, W. (2018). Global Advances in Value-Based Payment and Their Implications for Global Health Management Education, Development, and Practice. Frontiers in public health, p. 6.
French-Bravo, M., & Crow, G. (2015). Shared governance: The role of buy-in in bringing about change. Online journal of issues in nursing, 20(2).
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Question 
- As decisions are made to address changes in reimbursement in your workplace, how are these changes shared with the nursing staff?
- What suggestions do you have that could increase nurses’ awareness of healthcare financing issues?
Reimbursement & Financing Issues
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- Your initial post should be at least 600 words, formatted and cited in the current APA style with support from at least 3 academic sources
Online Materials & Resources
- Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes.pdf Download Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes.pdf
Cunningham, P., Rudowitz, R., Young, K., Garfield, R., & Foutz, J. (2016). Understanding Medicaid hospital payments and the impact of recent policy changes (Issue Brief). The Henry J. Kaiser Family Foundation and The Kaiser Commission on Medicaid and the Uninsured. - The Effect of the Magnet Recognition Signal on Hospital Reimbursement and Market Share Download The Effect of the Magnet Recognition Signal on Hospital Reimbursement and Market Share
Karim, S. A., Pink, G. H., Reiter, K. L., Holmes, G. M., Jones, C. B., & Woodard, E. K. (2018). The effect of the Magnet Recognition® Signal on hospital reimbursement and market share. Nursing Economic$, 36(3), 110–120. - Economic Impact of Opioid Use Disorder Epidemic Download Economic Impact of Opioid Use Disorder Epidemic
Neville, K., & Foley, M. (2020). The economic impact of the opioid use disorder epidemic in America: Nurses’ call to action. Nursing Economic$, 38(1), 7–51.