Health Care Financing: Evidence-Based Practice

Rapid and complex changes in healthcare financing might have a negative impact on nursing practice and health outcomes. Healthcare financing includes taxation, government funding, insurance, voluntary aid, and donations (RAND, 2020). Since the nurses are responsible for regular documentation of daily, weekly, and annual productivity results, reoccurring changes in the budget of medical facilities cause confusion and problems with the cost-effectiveness of nursing care (Murray, 2017). Patient outcomes greatly depend on effective management of healthcare finances, so any changes require nurses and staff to adapt to the innovations or seek leadership support to meet the needs of patients. As a nurse, I regularly encounter vulnerable patients from low-income families or the LGBTQ community who have serious health problems because they did not have access to healthcare services prior to the Affordable Care Act. The policy provided insurance coverage and affordable screening options for previously underserved populations, so the number of patients in our healthcare facility significantly increased along with the nursing workload. Moreover, previously uninsured patients have poor health outcomes caused by inadequate healthcare financing before the ACA and complications of untreated conditions. The rapid changes in financing result in frequent patient readmissions undermining the quality of care and outcomes.

Evidence-based practice (EBP) and interprofessional collaboration are vital in the nursing practice and help to effectively manage the constant changes in healthcare financing. According to the American Nurses Association (ANA) (2015), the nurses should assess the needs of a patient, select appropriate services addressing the needs, and identify the impact of resource allocation on the potential outcomes. It is essential to use EBP to respond to the tasks mentioned above. The approach helps nurses to ask questions, identify problems, seek evidence, and utilize it to request funding for a specific cause to prevent financing shortages in critical areas of clinical practice. Moreover, the nurses should be able to direct organizational and community resources towards the development and implementation of interprofessional plans (American Nurses Association, 2015). Interprofessional collaboration, including nurse leaders, physicians, nurse informaticists, management of a healthcare faculty, and policymakers, is another critical aspect of managing financing changes. Cooperation with legislators can impact financing changes in terms of adjusting taxation or insurance rates. Interprofessional teams guided by a nurse leader might combine their knowledge to develop projects attracting volunteers and donations for a particular cause requiring additional funding after the changes.

The understanding of healthcare financing is important for nurses, as it helps them to become better advocates for patients and resources. American Nurses Association (2015) states that nurses should advocate for resources supporting and improving nursing practice. Health economics is concerned with the allocation of resources in healthcare systems, so the knowledge of the discipline might improve the nurses’ finance-related decision-making (Mason et al., 2021). The nurses can suggest appropriate changes in resource allocation when there is an evident need to advocate for better treatment or alternative payment solutions for a certain patient. The understanding of health economics and financing is especially important for the prevention of unfair or financially unjustified treatment, which is often the case with LGBTQ patients. Moreover, financial competence allows the nurses to advocate for cost-effective healthcare that combines reasonable treatment costs and desired health outcomes. Finally, the nurses’ knowledge of healthcare financing might reduce patient readmission rates, emergency room visits, and unnecessary medication prescriptions through the effective allocation of financial resources.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring.

Mason, D. J., Dickinson, E. L., Perez, A., & McLemore, M. R. (Eds.). (2021). Policy & politics in nursing and health care (8th ed.). Elsevier.

Murray, E. (2017). Nursing leadership and management for patient safety and quality care. F. A. Davis Company.

RAND Corporation. (2020). Healthcare financing. Web.

bottom of post
Scroll to Top