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NURS 6211: Finance and Economics in Health Care Delivery | Week 4
Imagine you are the nurse manager at a small university medical clinic. As you sit in your office, preparing the budget for the coming quarter, what types of factors do you need to consider? You need to ensure that you have enough money to keep the facility operational. You have to consider how you will be reimbursed for services provided. Will you be paid per student or per individual service performed? Consider the daily costs of operating the clinic. How much will you need to pay nurses and receptionists? How much will you need to cover the purchase of medical supplies? What if there was a flu epidemic on campus? How would that affect your costs?
As a nurse manager, you need to understand how cash flows in or out of your organization or department, and the importance of tracking cash flow to keep operations running smoothly. This week, you consider the different reimbursement approaches used by health care organizations and how fixed and variable costs impact cash flow and net revenue.
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Learning Objectives
Students will:
- Distinguish between fee-for-service and case-based service
- Evaluate reimbursement approaches used by health care organizations
- Calculate fixed, variable, and semi-variable costs
NURS 6211 Week 4: Understanding Revenue and Cost Classifications essay assignment
Discussion: Reimbursement for Services
There are a number of different options for determining how to charge for services provided at a health care organization. In the case-based service approach, one set fee covers an entire procedure. For example, if you needed knee replacement surgery, the fee would include preliminary visits, the surgery, and follow-up visits. However, in a fee-for-service approach, every different step would incur a separate cost. The reimbursement approach taken has significant ramifications for how care is provided.
To prepare:
- Review the information in this week’s Learning Resources focusing on reimbursement for services. How are these approaches the same or different in your own setting?
- Identify an example of a fee-for-service approach and a case-based service approach.
- Reflect on the benefits and limitations of each approach.
- Review the article, “Which Health care Payment System is Best?” and examine the additional reimbursement strategies described. Consider the viability of these alternative strategies within your own organization (or one with which you are familiar).
- Examine how the nurse-to-patient ratio is affected by the payment approach used and consider how this can impact quality of service.
NURS 6211 Week 4: Understanding Revenue and Cost Classifications essay assignment
By Day 3
Post an example that illustrates the difference between a fee-for-service payment and a case-based service payment. Explain the benefits and limitations of each approach. Assess the viability of utilizing, within your own organization (or one with which you are familiar), the two alternative reimbursement strategies described in “Which Health care Payment System is Best?” Analyze how the nurse-to-patient ratio is affected by the payment approach selected and how these impact quality of service.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days. Expand on a colleague’s posting concerning the viabilities of the different reimbursement strategies. Suggest an alternative that might work within their organization and provide the reasoning behind your choice. Highlight any personal experiences with alternate strategies and how the strategy used impacted service.