Purpose
The purpose of this discussion is to explore the DNP-prepared nurse’s role as a member of the interprofessional team to design systems that optimize reimbursement with a goal to improve the quality of patient care. You will examine the influence of healthcare reimbursement on nursing practice, clinical outcomes, and cost issues.
Instructions
Reflect upon your readings and professional experience regarding reimbursement issues and address the following:
- Analyze if value-based insurance reimbursement influences clinical outcomes and healthcare equity.
- Determine the role of the DNP-prepared nurse in influencing nursing practice with regard to reimbursement.
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Answer Guide
Value-based insurance reimbursement is a model that rewards the providers based on the quality of care rather than quantity. Providers are therefore rewarded based on factors such as access to care, pricing, patient outcomes as well as efficiency. This model has a positive impact on health outcomes because the provider compensation is tied to the patient outcomes rather than the number of visits or diagnostic attempts that the patients have had. This approach pushes the healthcare provider to provide the best care possible and adopt metrics to measure the quality of care provided. The model also influences health outcomes because it encourages physicians to adopt a cost-effective care plan and focus on reducing complications, which in turn decreases the utilization of unnecessary procedures and tests and improves patient outcomes (Grobaty et al., 2020). This model also encourages physicians to reduce the cost of care as well as improve the utilization of preventive care. A study by Trapani et al. (2019) reported that valued based approach is fundamental in ensuring timely access to medication and breast cancer care. This in turn improves patient outcomes.
A DNP-prepared nurse can influence nursing practices with regard to reimbursement through leadership that encourages a culture of quality and safety in patient care. This is by ensuring that patient care and improved health outcome is prioritized. A DNP- the prepared nurse can also use knowledge and skills in evidence-based practice to influence the nursing practices such as integrating evidence in clinical decisions to improve health