[OldMareLPN]

John M. Welton, PhD, RN Clara E. Dismuke, PhD Medical University of South Carolina 05/2008

"There has been growing concern about the costs and intensity of inpatient nursing care, which consumes more than 40% of hospital
direct costs and $165 billion each year.

Allocating nursing labor as an average cost per patient and charged as room and board creates cost compression, distorts hospital payment, and hides the economic value of nurses.

This article examines a method for adjusting daily room charges using nursing intensity weights assigned by the diagnosis related group.

The overall findings of this study are that a nursing intensity adjustment to existing inpatient billing improves explained variance in total hospital costs.

Incorporating a nursing intensity adjustment into the existing reimbursement structure would improve payment accuracy."
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[oramar]

good, finally

[pinoyNP]

This research is a positive boost that is long overdue. CMS can not continue to see nurses as invisible in terms of revenue value.

[rcmhrn]

so tell me how do you develop a chargemaster for a small CHA hospital incorporating this idea?

[Suesquatch]

Originally Posted by rcmhrn

so tell me how do you develop a chargemaster for a small CHA hospital incorporating this idea?

CAH's don't bill/get reimbured on the DRG model. We couldn't survive.

[nerdtonurse?]

It won't make a difference, the patients we get that take the most "nuisance" nursing hours (at our facility anyway) have never paid their bill and won't start just because it's got "nursing hours" on it.

And can't you just see it if they started billing nursing hours by the tracker time in the room? You'd have pts meeting you at the door for you to give them their meds in the hallway, change their dressing in the waiting room....and d/t the high rate of "non payers" we'd be chased all over creation by management for "minutes per patient" overages...."They've only got one AKA, so you are alotted 6.2 minutes per hour with that pt, and you spent 12 minutes at 0200. Therefore, you're getting a demerit for not managing your time better, I don't care if you had to give them a bath because the aide didn't show....."

Dear god, the march of the MBAs continues.....

[ocankhe]

What professional doesn't bill for their services? This is an attempt to show that nursing is a true revenue generator in all areas of health care and not a cost that has to be CONTROLLED or cut.

[daisey_may]

At the hospital I worked at previously, I always thought i was interesting that pharmacy billed and was paid for the service of the nurse ADMINISTERING the medication to the patient even though it seems to have little to do with the pharmacy...

[rnsusan]

Where I work we have been doing that for over 20 years. We use the same tool that we use to decide on staffing levels. The only problem is that we need a good audit system. If nurses rate the patient as a higher acuity to improve staffing, then the patient gets charged to much.