Current Policy/Proposed Policy Essays Example

Current Policy

The current nurses’ reimbursement policies in Florida are in support of the direct reimbursement which is to the nurses rather than the normal reimbursement that is provided to the physicians. The bill further states that the provisions stated are not restricted to a particular location of practice. This is unlike in previous practices where reimbursement was restricted to a particular location which was most preferably rural areas (AANP, 2012). The bill further stated that reimbursement is restricted to long term care facilities and follow up care. Despite the reimbursement rate that are in existence, there has been a need for further reimbursement rates that need to be provided for different circumstances. The current reimbursement rates state that nursing practitioners be reimbursed at a rate of 80% which is lesser than the actual charge which is supposed to be at 85% that is allocated to physicians (AANP, 2012). The reimbursement rate is further diversified to meet different circumstances such as assistance in surgery where the reimbursement rate stands at 80%of the 855 that would have been compensated to a physician. The same rates apply to nursing practitioners who are working at the same circumstances in rural areas. The concerns that do exist is that a lot of money might be lost given that nurses are not able to cash in the 100% reimbursement rate that is supposed to be issued to physicians (AANP, 2012). The existing policies have been witnessed to unreasonably drive up the cost of health care. Through these policies, it is evident that there have been delays in and difficulties in accessing eligible health care. Through the current system inefficiency has been promoted, this is through the minimal utilization of the available nursing staff. Through these limitations, it is likely that there will be delays in quality care provision. This is despite the aims that the policies were expected to establish. Through the challenges that are evident in the current policies, transparency in care is affected since it is driven to a minimal rate. The current policies have failed to consider a wide range of factors that need to be considered in establishing the correct reimbursement rate. Failing to consider diverse factors has affected the quality of health care since the nursing practitioners are not delivering to their level best (Online sunshine, 2015). This is attributable to low motivation in their work. Despite the passion that is required in any profession, there is a need to ensure that adequate compensation is provided for the services offered. This can only be achieved through acknowledging the need of appropriately reimbursing the nursing practitioners, which is only attainable through a change in the existing policies (AANP, 2012).

Proposed Policy

It is important to acknowledge that nurses play a major role in health care provision. Their role is quite significant due to their constant involvement with patients. It is due to nurses that doctors can follow up on patients and continue to check remotely on their progress. However, despite the role that they play, there are concerns regarding the reimbursement that they have been receiving (Brunt, & Jensen, 2010). The quality of work that employees do, should be acknowledged through proper payment—reimbursement. In this instance, the proposed policies call for increased reimbursement rates for nurses that provided assistance in surgeries. This is unlike in the current reimbursement policies where there is no 100% reimbursement that is allocated to physicians that give assistance in surgery (Tatkon-Coker, 2007). Through improved reimbursement rates, it is likely that little money will be lost since payment will be issued out at 100% cutting down on money lost. In the proposed policy, the abolishment on the reimbursement that is used on follow-ups will be abolished as it is not in support of equality (Florida State of Department, 2015). This is because it restricts the number of patients that are followed up on to ensure that there is proper health care provision. Nurses need to be provided with reimbursement based on numerous factors. Nurses are required to be compensated based on numerous factors that they encounter in their area of practice. Reimbursement should also be based on other diverse factors that may include location of service, hours of work and the environment that they are exposed to while providing health care provision (AANP, 2012). Through considering these factors, it is likely that there are nurses who work under more harsh conditions compared to other and require adequate compensation for the services that they provide. Through proper reimbursement, it is likely that they will be motivated to providing advanced and quality health care provision. This is because their efforts are acknowledged and appreciated through proper reimbursement (Drummond, Jönsson, Rutten,& Stargardt, 2011). Through earlier studies, it is clear that the underperformance witnessed had been due to little acknowledgment of the role that nurses play. After the research had been completed, it was established that there is a need to make sure that there is adequate reimbursement provided. This will be a form of motivation that will reassure them of their position and the role that they play in health care provision. It will be effective in creating a more suitable environment for health care provision (AANP, 2012). Standards will be improved resulting inefficiency in the current health care system. These are among the factors that were considered while developing the proposed reimbursement policy.

Stakeholders

The significance, which the changes brought about by a change in policy, is inevitable. The numerous changes that will be experienced through the changes in policy are likely to be beneficial to a majority of the persons that are directly and indirectly associated with medical care provision (Kulesher, 2003). The proposed changes will be beneficial to patients this is due to the impact that the changes will have in regards to the kind of services that they receive. It is expected that through proper reimbursement policies that nurses will be motivated to providing quality care to their patients. This is due to the compensation that they receive for their work. Compensation in this instance is important since the value of their work is determined through the reimbursement that they receive (Thorpe, & Harty, Mary-Beth, 2010). Therefore, through adequate reimbursement, it is expected that there will be proper and adequate services offered to the different patients who seek medical attention. Adequate reimbursement is important since nurses are important and are essential in the health care system; therefore, they require to be listened to whenever the existing policies are not meeting their needs (Tatkon-Coker, 2007).
Health institutions are also set to benefit from the changes in policy. This is due to the reputation that they are likely to acquire out of the services that that their staff provides. The services provided as earlier explained are likely to improve due to the changes in policy. A good reputation will facilitate refer of more patients to a particular institution in search of quality care provision (Online sunshine, 2015). Through this, an institution will have attained its objectives since a health care’s objectives are solely based on ensuring that they provide quality health care to the community at large. The cost of health care will also be brought down to affordable rates for the government, and other concerned departments will set aside funds that are aimed at ensuring there is quality health care provision in the country (Florida State of Department, 2015).

Expected Outcomes

Nurses are among the primary health care providers; it is important to ensure that they are well evaluated to facilitate quality care provision. Through properly analyzing the challenges that they encounter in practice is essential in improving the health care system. Through the change in policy that has been recommended, there will be room for proper care in a medical institution (Tatkon-Coker, 2007). All this will be facilitated by the nurses who will be well motivated. The motivation is evident from the reimbursement that they receive for the services that they offer. Proper motivation can only be achieved if the nursing practitioners are given adequate reimbursement to the services that they provide. Through this, it is expected that the nursing practitioners will provide the best services to patients. Quality care provision in this instance will have been achieved. This is unlike in current practices where there is ineffectiveness since the nursing practitioners are not well motivated due to the little motivation that they get in terms of compensation (Tatkon-Coker, 2007). Regardless the passion that nurses may have for their work, it is important to appreciate their work through giving them the right payment for their work. This will help them build confidence in themselves since it is evident that their services are required and appreciated. Stakeholders are also set to benefit from the changes in policy regarding reimbursement. This is because the cost of care will be guaranteed and at a reasonable rate. This is unlike in the existing policies where there are no appropriate reimbursement channels. Through the current policies, it is likely that there will be the establishment of funds aimed at providing appropriate reimbursement (Reimbursement of Mental Health Services in Primary Care Settings, 2008).

Personal Thought

Having reviewed the existing policies on reimbursement, it is evident that there are changes that need to be made. The changes are inevitable due to the growing pressure that has been in existence regarding the current reimbursement policies. It is evident that nurses currently do not receive adequate compensation for their work. This is despite the diverse working environment that they are exposed to while in practices. Their role is quite major in health care, and it is required that proper reimbursement should be granted. This will be effective in ensuring that nurses can participate effectively in their different roles in health care provision. Through acknowledging the major role that we play and giving adequate reimbursement, it is likely that there will be increased efficiency and quality health care provision. Patients will be attended to effectively and receive the best medical attention. Every patient will receive the attention that they deserve and be attended to in a professional manner. The proposed policy change is set to ensure that all nursing practitioners receive the compensation that they deserve. This is because, there are nursing practitioners who work in very remote areas and under very difficult circumstances and need be provided with an advanced reimbursement rate compared to others. Through this, it is evident that that the policy change is inevitable in order to meet the diverse available needs of the nursing staff. The rates that have been proposed are set to be fair and promote transparency. Through the implementation of this policy, it will be expected that there will be improved medical care provision.

References

American Association of Nurse Practitioners (AANP). (2012). Medicare Legislation. Retrieved on 2nd February 2015 from, http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/325-medicare-reimbursement
American Association of Nurses Practitioners. (AANP). (2015) State Practice Environment. Retrieved on 2nd February from, http://www.aanp.org/legislation-regulation/state-legislation-regulation/state-practice-environment
Brunt, C. S., & Jensen, G. A. (2010). Medicare part B reimbursement and the perceived quality of physician care. International Journal of Health Care Finance and Economics, 10(2), 149-70. doi:http://dx.doi.org/10.1007/s10754-009-9075-1
Drummond, M., Jönsson, B., Rutten, F., & Stargardt, T. (2011). Reimbursement of pharmaceuticals: Reference pricing versus health technology assessment. The European Journal of Health Economics : HEPAC, 12(3), 263-71. doi:http://dx.doi.org/10.1007/s10198-010-0274-y
Florida State of Department (2015). Florida workers compensation reimbursement manual for hospitals. Retrieved on 2nd February 2015 from, https://www.flrules.org/gateway/ruleno.asp?id=69L-7.501
Kulesher, R. R. (2003). The influence of medicare reimbursement policy on health care: How the balanced budget act of 1997 impacted medical services in delaware (Order No. 3100101). Available from ABI/INFORM Complete. (288073099). Retrieved from http://search.proquest.com/docview/288073099?accountid=45049
Online sunshine. (2015). The 2014 Florida Statues. Retrieved on 2nd February 2015 from, http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0464/0464.html
Reimbursement Of Mental Health Services In Primary Care Settings. (2008). Medical Benefits, 25(17), 12. Retrieved from http://search.proquest.com/docview/207253024?accountid=45049
Tatkon-Coker, A. (2007). The relationship of medicare and medicaid reimbursement on job dissatisfaction and spousal influence on the retention of rural health practitioners in north central iowa and south central minnesota (Order No. 3268680). Available from ABI/INFORM Complete. (304719337). Retrieved from http://search.proquest.com/docview/304719337?accountid=45049
Thorpe, J. H., J.D., & Harty, Mary-Beth,J.D., M.P.H. (2010). Medicare reimbursement trends: Impact of quality improvement and cost reduction initiatives on health care finance and leasing. ELT, 26(3), 28-31,33,35. Retrieved from http://search.proquest.com/docview/893916108?accountid=45049