Cost of healthcare effecting care plans?

[studentMay2010]

Hello!

I am a Senior nursing student, and for a class we have an assignment to interview a nurse manager (though I think other nurses would have good input on this as well).

We are to analyze a hospital bill- we all know how much healthcare costs, and how those bills add up fast.

The question for nurses and nurse managers is: How are nursing care plans are effected by the cost of healthcare?

In other words, how are rising healthcare costs effecting us as nurses in the care we give to our patients. Also, Do you have any ideas on how to decrease these costs, or balance the costs and care more effectively?

Thank you all in advance for your help, I really appreciate it!

[itsmejuli]

If I was doing this research article I'd go into a hospital and interview 3 people. The first would be someone in budgeting, next would be a nurse in utilization review and then a floor DON.

This could be a very interesting paper.

Then again, sometimes I get too carried away in research paper assignments.

[Daytonite, BSN, RN]

everyone has to be cost conscious. i was recently hospitalized and something i noticed nurses doing was that they didn't fill their pockets with a lot of extras or put a lot of extra equipment and supplies in patient rooms anymore. i was used to doing that as a nurse years ago. now, if my dressing needed to be changed the nurses had to go and get exactly what they needed--even towels and bed linens. less and less unnecessary time is spent with patients. every moment is precious and unwasted. if a nurse can multitask, so much the better. something you need to know about billing is that medicare, one of the primary payers of hospital inpatient bills pays by drgs which is a lump sum payment and usually less than what the hospital coder/billers estimate they are going to receive from medicare, so the hospitals have learned that they really need to conserve on what they expend for each patient. i am a medicare patient and i wish i could show you what the hospital has charged medicare for my hospitalizations and what medicare actually paid them.

[studentMay2010]

Thank you both for replying so quickly!

@itsmejuli: I agree, it could be a really cool paper... though I only need it to be one page, just a quick little commentary (luckily!) But if I run into anyone in those roles you mentioned, I'd be sure to ask them.

@Daytonite: Thanks for your perspective as a nurse and as a patient- I hope you get better soon! You provided a very simple way to cut costs- don't waste supplies! Your comments about DRG's and Medicare are also enlightening- I'll have to look more into that, and how it may effect the care that nurses can give to their patients (maybe it does maybe it doesn't).

Thanks again!

[Daytonite, BSN, RN]

@Daytonite: Thanks for your perspective as a nurse and as a patient- I hope you get better soon! You provided a very simple way to cut costs- don't waste supplies! Your comments about DRG's and Medicare are also enlightening- I'll have to look more into that, and how it may effect the care that nurses can give to their patients (maybe it does maybe it doesn't).

Oh, believe me, it does. As a manager and supervisor I can tell you that supplies started dwindling off our central service carts, less of things were carried on them, different and cheaper brands started being used. I don't know if people are aware that those "kits" of all kinds that are supplied on the carts can be custom made for each hospital and the expense of them is based on what goes into them, so when you hear nurses grumbling that something is no longer part of this irrigation kit or that start kit, that may be why. Admission kits for patients used to include all kinds of goodies which are no longer supplied--cost is the reason. I tried to get a small bottle of baby powder when I was an inpatient in the hospital 3 weeks ago. Forget it. We were told in management meetings that freezes were being put on new hiring and as staff left through attrition we pretty much had to deal with it and find creative ways to cope. The staff gets overworked and tired because their patient loads go up and they blame managers. In management meetings we had to listen to the financial guys give the figures on delinquent accounts and crap the insurance companies were giving them. When I could no longer work as a nurse I started learning medical records and medical coding and worked as a coder/biller (which is why I know so much about Medicare, DRGs and insurance company payments to hospitals). The big and small private insurance companies just change their reimbursement rules with providers of healthcare at their whim usually lowering reimbursement or just outright denying claims. They are looking at their bottom line profits when they do this. This is why big outfits like hospitals try to get locked into contracts with these jokers and the insurance companies don't like it because it doesn't give them much wiggle room. When I was a coder we had weekly staff meetings, and sometimes daily updates, on insurance company shenanigans and what they had decided they were not going to pay for or had decided to pay pennies for instead of dollars.

And that, kiddo, is another aspect of this whole situation.

Flip the coin and look at the marvelous inventions being used to detect and treat disease. They don't come cheap. Research of new drugs is expensive and when a new drug does come out the drug companies need to reclaim what they expended to get the drug to market. The result. . .sky high prices on new drugs. Have you noticed how some drug commercials on TV for these new wonder drugs are saying at the end that if you might have difficulty paying for the medication that the company might be able to help. Only of you make below a certain income and sometimes the drug reps leave rebates with docs to pass on to patients to who they prescribe the drugs. Try contacting some of these drug companies about financial help for some of these drugs and get the paperwork and see what you are told. The same goes for some of the medical equipment being used. In 1975 when I graduated we did manual blood pressures and eyeballed and manually titrated our IVs. Look up the cost of a Dinamap that does the blood pressure, pulse, temp and pulse ox or any IV pump. Have you even got that much money in a savings account? Check out the price of a fully loaded Hill-Rom bed. I had a friend that worked for this corporation. When a hospital decides to buy a bunch of new beds it is a HUGE expense.

Have fun as well as an eye opening with this assignment. When I did my BSN we had to do a shopping assignment in medical supply stores as well as look at other health care costs.

(Before I became a nurse I was a bookkeeper and was 2 years away from getting my Bachelor's degree in Accounting. Balancing the books means that the money coming in [Accounts Receivable] must equal the money being saved [working cash] and/or being paid out for expenses [Accounts Payable].)