• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible. References should be from at least 5 years.

Discussion #1

Healthcare reimbursement refers to the payment made to doctors, hospitals, diagnostic facilities, and other healthcare stakeholders for their exchanged medical services. In most cases, the government payer or healthcare insurer covers the relevant costs of the whole or section of one’s healthcare costs. Based on one’s health plan, a person might be accountable for a specific cost, and if one does not have coverage, then the person is responsible for reimbursing the health care providers for the complete cost of health care (Alghamdi, 2018). Considering the recent crisis in the United States healthcare sector, there has been some overhaul and changes in reimbursement models to impact healthcare service delivery. Nursing staffs are a crucial factor in service delivery and healthcare finance as the two are intertwined. Addressing changes in reimbursement thus needs to be communicated to nursing staff to align nurses and finance professionals best to steer value at healthcare facilities and health systems.

Addressing these changes requires that a reimbursement model be developed that matches the healthcare service delivery offered by the nursing staff. Reimbursement change models help to raise the value of the services and reduce the costs of healthcare services in public health. Some of the critical areas that are vital for reimbursement changes in nursing are cost and quality outcomes, program planning, workforce, patient quality and safety, and education (Torrey, 2019). In communicating such changes in a nursing environment, hospital finance executives and nursing leaders work closely to institute and enact a financial reimbursement change that would work as lenient to patients as primary beneficiaries and nursing fraternity as the major service providers. According to Torrey (2019), coordinated planning based on hospital programs and workforce development is crucial to dealing with healthcare financial issues. Thus, nurse leaders must be intimately incorporated into the finance team to effect a smooth transition to a reimbursement change.

There is a significant change in healthcare reimbursement in the public health sector. Before features of the Affordable Care Act, there was still a focus on having value-based care versus the volume to be served. Such observations forced numerous healthcare providers and organizations to consider accountability and patient-centered care models in which they assume a larger share of risk. To increase healthcare financing issues in a changing climate, management of revenue must be done differently to guarantee that value delivered to patients is settled appropriately in regards to accuracy and timeliness (Heydari et al., 2018). For nursing staff and hospitals to guarantee that their dues are paid duly, they must understand how diverse components of claims management influence reimbursement models.

Increasing knowledge of healthcare economics is sufficient in spreading awareness about healthcare reimbursement and other financial issues. Lack of health economic education during medical training is one primary reason for inconsistency and alignment of nursing practices to existing financial needs. Nurses must thus be equipped with the opportunity to represent their value from an economic standpoint (Whedon et al., 2017). Their awareness in healthcare economics, participation, and logical justification for hospital costs is of vital importance. Through it, different organizations can boost nursing awareness on financial issues in a quest to provide high-quality services in return. A combination of healthcare service delivery factors and financial information maximizes efficiency and also effectiveness derived from the clear economic assessment.

Changes in reimbursement in healthcare is an ever-emerging process that requires prompt communication and incorporation of nursing staff. However, it is ascertained that nurses have insufficient awareness regarding health finance. Given the importance of healthcare finance and its attributes to service delivery, nursing finance management and a grasp of healthcare economic are vital in addressing healthcare financing issues. Considering the significance of current healthcare systems, nurses need to equip themselves with knowledge of nursing finance and economics. This would ultimately improve quality standards while developing their clinical behavior.

Discussion #2

As a private organization, most of our funding comes from either donors or grants. We have a development department that consistently researches grants and apply for them. Every few months we have a huge gala that bids off jewelry, art, and clothing. 100% of the proceeds goes to our facility. If one of our facilities need a particular item for their facility or client, the facility contacts a donor to try obtain the item in need. In each facility, is a glass wall and engraved in it is the names of the “godparents”. These godparents are essentially donors who take a lifetime commitment to our facility. Every year the godparents make $100,000 contribution to our facility.

Leading to Summer Camp, we receive numerous grants. After all the funds are contributed to the clients and funds got to the supplies needed, the remaining of the funds gets contributed to the different departments throughout the facility. The supervisor of each department is allowed to determine how the funds are spent. The funding can either go towards specific supplies needed for their department or a staff appreciation luncheon for their department. Being I am the nursing supervisor; I always choose supplies needed for our department. Mostly because the agency does a staff luncheon every month anyway. Once a year, most employees receive a raise. During the start of the pandemic, the agency couldn’t afford to give out the yearly raises and bonuses. COVID-19 has increased the financial strain on healthcare providers, but that strain predates the pandemic (Shill, 2022). The supplies I require are expensive and when I request them, they are denied because of the pricing so I take advantage of the opportunity to get the supplies we need when the opportunity presents itself.

Operating budgets help managers administer the daily operations that feed the financial reporting process (Johnson, 2017). The end of each month I review our budget. I review how much we are spending on supplies and determine if we are being negligent with our spending. Gains and loses refer to increases in assets (gains) and conditions where liabilities exceed assets and result in losses, which are usually measured monthly, quarterly, or annually. I attempt to be as transparent with our department finances with my nurses as much as possible. My perspective is if they understand the various types of costs, they can more effectively manage them.

Being transparent with the nurses’, increase their awareness of health care financing issues. Encouraging and implementing training to the nursing staff can also help raise awareness on healthcare financing. If the nursing staff is adequately trained on development and methods to reduce costs, they will possibly be more motivated to be more involved in the healthcare financing. The training would also assist the nurses in methods of managing the financial costs of the agency. It must be a collaborative effort for it to work efficiently. All parties involved must be consistent in the ways to reduce costs for it to be effective.