Healthcare payment reform and implications for nursing compensation and quality care

Health Care Payment Reform

Buerhaus, Welton, and Rosenthal wrote and spoke about the way changes are hoped to be made in terms of the health care system and the way providers are paid, particularly hospitals and physicians. The hope is that changes in the payment system will produce greater output without being unfair to staff, reducing the quality of care and access to the people.

The disadvantages between the current system and proposed system are that currently, nurses aren't paid outright and there's a standard fee for care. This means there is an imbalance of work load, despite the amount of care needed in a variety of patient rooms and diagnosis. Currently, hospitals generate more profit and makes a fixed payment per patient that walks in those doors, and a daily room rate. The payment system now pays for the amount of help needed for each procedure, the time spent, visits, and hospitalizations. The system's incentive consists of the sicker the patient is and more care given to him or her, which translates to "if a provider does something to keep the patient population healthier, they will be paid less." In the end, the incentive isn't a great or positive one, and one that encourages minimal communication.

The advantages of the disentanglement of nursing costs and the proposal of the new payment system are that a price for nurses and their services will be instituted like doctors, and adjusted for diagnosis. This would affect nursing policy priority in that there would be a more logical and sensible system to how nurses are paid, and display the care nurses administrate to their patients. Furthermore, not only would good nursing care be rewarded but the heavy workload would be decreased and quality care would be increased and set forth. Nurses will finally have a say and a proposed solution is to use the nurse-patient assignment. It is a method to calculate how many hours nurses have put in to their patients, which would then reflect the care and sort nursing payment. In the end, nursing will be seen as an entrepreneurship and essential to the functioning of a hospital.