Assignment: NUR711 Week 7 Discussion: Reimbursement Issues

Assignment: NUR711 Week 7 Discussion: Reimbursement Issues

Assignment: NUR711 Week 7 Discussion: Reimbursement Issues

Reimbursement Issues

Discussion

Purpose

The purpose of this discussion is to explore the DNP-prepared nurse’s role as a member of the interprofessional team to design systems that optimize reimbursement with a goal to improve the quality of patient care. You will examine the influence of healthcare reimbursement on nursing practice, clinical outcomes, and cost issues.

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Instructions

Reflect upon your readings and professional experience regarding reimbursement issues and address the following:

Analyze if value-based insurance reimbursement influences clinical outcomes and healthcare equity.

Determine the role of the DNP-prepared nurse in influencing nursing practice with regard to reimbursement.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Link (webpage): DNP Discussion GuidelinesLinks to an external site.

Program Competencies

This discussion enables the student to meet the following program competencies:

Integrates scientific underpinnings into everyday clinical practice. (POs 3, 5)

Uses analytic methods to translate critically appraised research and other evidence into clinical scholarship for innovative practice improvements. (POs 3, 5)

Appraises current information systems and technologies to improve healthcare. (POs 6, 7)

Analyzes healthcare policies to advocate for equitable healthcare and social justice to all populations and those at risk due to social determinants of health. (POs 2, 9)

Leads others in professional identity, advanced clinical judgment, systems thinking, resilience, and accountability in selecting, implementing, and evaluating clinical care. (POs 1, 4)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

Examine the role of the DNP-prepared nurse in leading financial planning and management across healthcare settings. (PCs 5, 8; POs 2, 4, 9)

Develop strategies to lead project planning, implementation, management, and evaluation to promote high-value healthcare. (PCs 1, 3, 4; POs 3, 5, 7)

Assignment: NUR711 Week 7 Discussion: Reimbursement Issues Sample

As a DNP nurse committed to addressing staff burnout and compassion fatigue in my practicum organization, analyzing how reimbursement mechanisms, particularly value-based insurance reimbursement, impact critical aspects of care is essential. This paper aims to explore the role of DNP-prepared nurses in designing systems that optimize reimbursement to enhance the quality of patient care and understand the role of the DNP-prepared nurse in influencing nursing practice.

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Value-Based Insurance Reimbursement and Clinical Outcomes

Eriksson et al. (2022) emphasize that value-based insurance reimbursement is a pivotal shift in healthcare financing, prioritizing quality and effectiveness over sheer quantity. This approach drives healthcare providers to prioritize high-quality care, a shift that has profound implications for clinical outcomes. By financially rewarding organizations for improved patient outcomes, value-based reimbursement compels them to implement evidence-based practices and enhance care coordination, ultimately fostering better clinical outcomes.

Additionally, value-based insurance reimbursement promotes preventive care and early intervention, which directly impact clinical outcomes (Lewis et al., 2023). For instance, incentivizing preventive and holistic strategies can help to address staff burnout and compassion fatigue by preventing the actual occurrence of the diseases and high patient acuity. Consequently, clinical outcomes are poised to improve as nurses can dedicate more time to patient care and preventive measures. This paradigm can also improve healthcare equity, guaranteeing all access to quality care regardless of socio-economic status. For example, value-based insurance reimbursement catalyzes a transformation in healthcare delivery, aligning incentives with improved clinical outcomes and equitable care.

The Role of the DNP-Prepared Nurse

DNP-prepared nurses are well-positioned to influence nursing practice in health organizations by advocating for value-based insurance reimbursement. As Ahmed and Wolf (2021) highlight, these nurses can serve as change agents, researching to demonstrate the effectiveness of interventions to reduce staff burnout and compassion fatigue. They can also collaborate with interdisciplinary teams to develop and implement evidence-based protocols that align with value-based reimbursement criteria. Furthermore, DNP-prepared nurses can act as educators, training fellow nurses and staff on the importance of prevention, self-care, and utilizing available resources to maximize value-based reimbursement incentives.

Conclusion

Value-based insurance reimbursement significantly impacts health organizations’ nursing practice, clinical outcomes, and cost issues. Value-based reimbursement encourages proactive approaches to addressing staff burnout and compassion fatigue, improving clinical outcomes, and promoting healthcare equity. DNP-prepared nurses play a vital role in influencing nursing practice by advocating for and implementing value-based reimbursement initiatives that benefit both staff and patients. Through their leadership and expertise, DNP nurses can contribute to transforming health organizations into centers of excellence that prioritize the well-being of their staff and the quality of care delivered.

References

Ahmed, S. W., & Wolf, K. A. (2021). Evolution to revolution: Positioning advanced practice to influence contemporary healthcare arenas. In connect.springerpub.com. Springer Publishing Company. https://connect.springerpub.com/content/book/978-0-8261-4019-7/part/p01/chapter/ch01

Eriksson, T., Levin, L., & Nedlund, A. (2022). Introducing a value‐based reimbursement program—Alignment and resistance among healthcare providers. The International Journal of Health Planning and Management. https://doi.org/10.1002/hpm.3574

Lewis, C., Horstman, C., Blumenthal, D., & Abrams, M. (2023). Value-Based care: What it is, and why it’s needed. Www.commonwealthfund.org. https://www.commonwealthfund.org/publications/explainer/2023/feb/value-based-care-what-it-is-why-its-needed