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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.

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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.