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

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Advanced practice registered nurses (APRNs) can enhance hospital reimbursement by leading quality improvement initiatives within the Hospital Value-Based Purchasing (HVBP) program. Demonstrating value through performance evaluation and project implementation is key to increasing financial returns.

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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.