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Value-Based Payment: What Does It Mean for Nurses?
Patricia Pittman1, Betty Rambur, Susan Birch
1The George Washington University, Washington, District of Columbia (Dr Pittman); The University of Rhode Island, Kingston (Dr Rambur); Washington State Health Care Authority, Olympia (Ms Birch); HealthImpact and the University of California, San Francisco (Dr Chan); University of Mary, Bismarck, North Dakota (Dr Cooke); The University of Utah, Salt Lake City (Dr Cummins); American Association of Colleges of Nursing, Washington, District of Columbia (Drs Leners and Trautman); University of Michigan, Ann Arbor (Dr Low); Quinnipiac University, Hamden, Connecticut (Dr Meadows-Oliver); Johns Hopkins University, Baltimore, Maryland (Dr Shattell); and Southern University and A & M College, Baton Rouge, Louisiana (Dr Taylor).
The COVID-19 pandemic exposed flaws in the fee-for-service healthcare model, highlighting the need for value-based payment reforms. Nurses must enhance their understanding of cost and quality to lead healthcare system transformation.
Area of Science:
- Health policy
- Nursing education
- Healthcare economics
Background:
- The COVID-19 pandemic revealed significant weaknesses in the current fee-for-service healthcare system.
- This has spurred bipartisan support for value-based payment reforms.
- Nurses possess a history of innovative care models crucial for healthcare delivery system reform.
Purpose of the Study:
- To examine the role of nurses in value-based payment reforms.
- To identify barriers hindering nurses' full participation in healthcare system redesign.
- To advocate for educational adjustments to prepare nurses for value-based care.
Main Methods:
- Literature review on healthcare payment models.
- Analysis of nursing's historical contribution to care innovation.
- Examination of educational curricula related to healthcare economics and quality.
Main Results:
- Deficits in educational preparation regarding cost-effectiveness hinder nurses' contribution to value-based payment discussions.
- Resistance to considering cost alongside quality impedes nurses' engagement in system change.
- Nurses are currently viewed as a labor cost within the fee-for-service system.
Conclusions:
- Addressing educational gaps will empower nurses to lead healthcare redesign for improved patient well-being.
- Shifting from a fee-for-service model can reposition nurses as value generators.
- Nurse administrators and educators must prepare the profession for this evolving healthcare landscape.
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