Hospital value-based purchasing: How acute care advanced practice nurses demonstrate value

Area of Science:

• Healthcare Administration
• Nursing Practice
• Health Policy

Background:

• The Centers for Medicare & Medicaid Services (CMS) implemented the Hospital Value-Based Purchasing (HVBP) program to link hospital payments to quality of care.
• The HVBP initiative aims to improve clinical outcomes and enhance patient experience in acute care settings.
• Advanced Practice Registered Nurses (APRNs) play a crucial role in the success of healthcare institutions under current US payer models.

Purpose of the Study:

• To provide an overview of the HVBP program structure.
• To describe how APRNs can influence performance measures within the HVBP program.
• To highlight how APRNs can demonstrate their value to healthcare institutions.

Main Methods:

• The article reviews the structure of the Hospital Value-Based Purchasing initiative.
• It outlines a four-step process for APRNs to demonstrate value: understanding standards, evaluating performance, identifying opportunities, and implementing projects.
• The focus is on how APRNs can positively impact performance measures.

Main Results:

• APRNs can leverage their expertise to champion quality improvement and patient experience projects.
• Successful project implementation by APRNs can lead to increased financial reimbursement for hospitals under the HVBP system.
• This demonstrates the tangible value APRNs bring to healthcare organizations.

Conclusions:

• APRNs are pivotal in navigating and succeeding within the HVBP framework.
• By actively participating in quality improvement, APRNs can directly impact hospital financial performance.
• The strategic involvement of APRNs is essential for maximizing reimbursement and demonstrating institutional value.