The SARS-CoV-2 pandemic demonstrated that the fee-for-service healthcare system failed to meet patients’ needs while also straining healthcare workers, notably nurses. Although it is widely assumed that payment should be focused on more expensive surgical therapies, several researchers disagree. As an aging society, the United States must invest in and build new nursing-focused care systems (Pittman et al., 2021). As a result, value-based care is advocated, which “provides an opportunity for nurses to enhance the role of nursing care and help redesign the health care delivery system” (Pittman et al., 2021, p. 185). It is crucial not only to tell nurses about reimbursement adjustments but also to empower them to make their own decisions in this regard.
My organization employs shared governance for informing reimbursement changes. The nursing team has a committee that notifies each team about how everyone is coping with the changes and any miscommunications. This strategy enables employees to discuss their issues and difficulties and identify shared solutions.
After all, even if the changes are good, many employees find it difficult to adjust to or comprehend these reimbursement adjustments. However, this is insufficient for employees to consider all reimbursement modifications valid. The difficulty is that the nursing personnel most involved in patient care are rarely heard, and the healthcare system is not designed to accommodate their expertise. As a result, nurses are burdened with heavy workloads and often have no idea how to manage healthcare costs, causing the system to collapse during crises.
First and foremost, if a new healthcare system is created with nurses and their input in mind, as value-based care is, nurses will be driven to learn about it. Above all, hospitals should prioritize nurses’ knowledge of healthcare funding. According to Rundio, “budgeting and finance are topics that are not addressed adequately in the typical nursing curriculum” (Rundio, 2021, p. 2).
After all, nurses have practical knowledge that allows them to understand how the budget should be allocated. Nurses should be given some ability to make these decisions, as well as the chance to grasp how the reimbursement system works, whether it is new, such as the Affordable Care Act, or not. The pandemic demonstrated that the healthcare sector is only concerned with problems when they become entirely ineffectual. Nonetheless, nurses may have found out early on how to avoid this type of situation in healthcare and reimbursement. However, it is not sufficient to simply teach nurses about healthcare economics and payment; nurses must also be heard when they have something unique to offer.
Nurses are a relatively underpaid workforce that has yet to be given the authority to make such significant decisions. Having said that, nurses do a variety of activities, are familiar with medical equipment, and provide direct care to clients. Special conferences, research, and committees for nurses would also be beneficial, allowing them to share their experiences and offer new solutions to new issues.
Nurses should have greater opportunities to publicly discuss their views and advocate for crucial issues such as funding (Rambur, 2021). In addition, if nurses were more informed of changes in payment or the new healthcare system, they may influence hospital policy on changes in certain businesses. It would be beneficial to be at least somewhat informed about the new system and any adjustments, as this would significantly shorten the transition period. Furthermore, even a basic understanding of healthcare funding concerns makes it much easier for nurses to engage with new systems.
References
Pittman, P., Rambur, B., Birch, S., Chan, G. K., Cooke, C., Cummins, M., Leners, C., Low, L. K., Meadows-Oliver, M., Shattell, M., Taylor, C., Trautman, D. (2021). Value-based payment: What does it mean for nurses? Nursing administration quarterly, 45(3), 179-186.
Rambur, B. (2021). Health care finance, economics, and policy for nurses: A foundational guide. Springer Publishing Company.
Rundio, A. (2021). The nurse manager’s guide to budgeting & finance. Sigma Theta Tau.