NUR435: Week 5 Discussion: Financial Considerations in Nursing

I’m studying for my Nursing class and need an explanation.

Step 1 Post your response to the discussion board.

Currently, nursing services are considered an expense for which healthcare organizations cannot bill separately. Respond to the following questions and, if appropriate, include personal experience as part of your answers:

  • Why are healthcare organizations unable to bill separately for nursing services, and what is the impact on nurse leaders?
  • What can the nursing profession, and specifically nursing leaders, do to change this issue?
  • Why are nursing services considered an expense and not an income generator?

Step 2 Read other students’ posts and respond to at least two of them by Friday at 11:59pm Mountain Time.

Ask questions of the other students that promote further thinking and discussion on the topic. Consider the changes to billing identified by the other students. Do you agree or disagree that these changes can make an impact on nursing services? Why or why not?

Use your personal experience, if it’s relevant, to support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support opinions.

Peer Discussion (Tina)

Several healthcare organizations are unable to bill separately for nursing services which imposes a negative impact on the nurse leaders. Due to the purpose of the documentation, the coding system and other requirements related to this process, medical institutions cannot charge only for nursing services (Kennedy, Wood, & Frieden, 2017). Nurses’ working hours can be calculated, but pay more attention to patients, and therefore, they cannot be registered. This effect reduces the payment process in the nursing field.

Nursing practitioners and nursing leaders can take specific actions to change this issue. The most exciting part of looking at healthcare as a cost is an opposite of what hospitals think of other healthcare providers. Doctors and most (but not all) different therapists (respiratory, specialist, and physiotherapist) are often seen as the cost of a service that earns a hospital income. To change this problem, the nurse needs to understand the billing process. They recognize the needs and conditions of their services. Care facilities must have written documentation.

The nursing services are considered an expense and not an income generator. Nurses provide intensive care to patients and work hard for early recovery, so they are seen as an expense rather than a resource to earn an income. On the one hand, our hospitals have to bear all the costs involved, which mean combat between the cases, which often needs the right number of nurses to be responsible for each service, while maintaining a budget reasonable (Wager, Lee, & Glaser, 2017). Of course, if there is no nurse to organize the work of the various departments, there is always someone who says that the reason for the hospital’s primary source of income is slow closure. In the absence of suitable nurses, physicians should limit admission, surgery, and other similar procedures and avoid income-generating forms.

References

Kennedy, J., Wood, E. G., & Frieden, L. (2017). Disparities in insurance coverage, health services use, and access following implementation of the affordable care act: a comparison of disabled and nondisabled working-age adults. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017734031. https://doi.org/10.1177/0046958017734031

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical approach for health care management. John Wiley & Sons. https://ir.ucc.edu.gh/jspui/bitstream/123456789/30…

Peer Discussion 2 (Patricia)

Why are healthcare organizations unable to bill separately for nursing services, and what is the impact on nurse leaders?

Nursing services are currently included in the inpatient hospital services billing and not accounted for separately (“Medicare,” 2017). Advanced Practice Nurses (APRNs) such as Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Nurse-Midwives (CNMs), Certified Registered Nurse Anesthetists (CRNAs) and other degree-credentialed nurses are able to bill for their services but registered nurse services are paid for under “incident to” the provider categories of practice expense (“Medicare,” 2017). Nurse leaders have to become more involved in the financial aspects of patient care and remuneration (Finkelman, 2015).

What can the nursing profession, and specifically nursing leaders, do to change this issue?

In order for this status to change, nurses and nurse leaders would have to become educated and involved in the legislative, economic, and budget processes of patient care. For RNs to be able to bill for services rendered, nurse leaders will have to drive the change by using “two potential avenues to change this result: 1) seeking a change in statute or 2) convincing CMS to use its section 1115A waiver authority to study direct payment to RNs” (“Medicare,” 2017, p. 23).

Why are nursing services considered an expense and not an income generator?

In healthcare organizations, nurses’ salaries are a budget item and considered to be an expense (Finkelman, 2015, p. 430). Unless provided by APRNs (advanced practice registered nurses), nursing services are considered “incidental to physician’s services” and as such cannot be directly billed for. They are an expense, not an income-generator (“Medicare,” 2017).

References

Finkelman, A. (2015). Leadership and management for nurses: core competencies for quality care. (3rd ed.). Boston, MA: Pearson. https://online.vitalsource.com/#/books/9781323400449/cfi/6/2[;vnd.vst.idref=cover]!

Medicare payment for registered nurse services and care coordination. (2017). American Nurses Association (ANA). https://www.nursingworld.org/~498582/globalassets/…

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