Being Bold

[Spartacvs, BSN]

Good Morning,

The incoming administration has been quite vocal on repealing the Affordable Care Act

(Obamacare) and I am sure administrations are worried about those changes and how it will effect their bottom lines. With that in mind I asked how can we get more for what we do and came across this article entitled "Testing an inpatient nursing intensity billing model" that outlines changing the billing system. They call it nursing intensity but it looks to me that its just another way of saying acuity.

Testing an inpatient nursing intensity billing model. - PubMed - NCBI

Some key points...

"If nursing care represents an independent treatment effect and is one of the largest resources expended by hospitals, then nursing hours and costs (nursing intensity) should be isolated and introduced as a separate variable..."

"... Nursing care was undervalued by 32% using fixed per diem rates compared to actual nursing time

and costs. For example, the cardiac step down unit had 44% of the intermediate care charges, but the actual mean nursing intensity and mean direct costs per patient for the unit was lower than several other units that were billed at the lower routine care rate."

The article concludes "... automatic data capture and direct linkage of nursing intensity and costs to the billing and discharge records may present a viable solution to improving payment accuracy, providing additional clinically meaningful data to examine trends and compare patient care..."

In these changing times we need to find better ways to get paid for what we do.

Bold ideas...

Regards,

-Matt-

[Double-Helix, BSN, RN]

I completely agree with this initiative. It has never made sense to me that charges for nursing care are rolled into room and board the same way that a house-keeping fee is rolled into a hotel bill. Documenting actual hours of nursing care and billing each patient appropriately is absolutely the best way for the nursing profession to ensure adequate staffing, provide justification for FTEs and negotiate higher pay.