Protecting Medicare Beneficiary’s for Bundle Payment
With bundled payments Medicare beneficiaries are offered a choice of what level of care they will receive regardless of physician orders. Hospitals offer a list of all participating providers within the patient’s service area, so that they can determine which provider they will use for their health care services. The hospital encourages the patients to seek better community service line areas out of the list providers that they have collaborated services to potentially enhance monetary gain. In order for the organization to achieve this goal educating patients who the higher quality providers are will be essential. To achieve these outcomes, an important part of the nurse executive’s role is to promote, and place focuses on methods the health care team can “reframe” their workflow to accomplish favorable patient outcomes (Dunham-Taylor & Pincszuk, 2010, p. 119). Information Technology for Bundled Payment An operational health information technology (IT) platform that links health care providers and permits them to actively manage patients is vital to the efficiency of any organizations pursuing to apply a bundle payment program (CMS, 2011). …show more content…
It will be important to generate reports that are necessary to classify at risk patients and compare organization’s performance to benchmarks. Reporting through information sharing through the electronic health record (EHR) and quality monitoring will be vital to ensure preferred provider practices and outcomes are in place for bundled payment participation. The key to an organization’s success in bundle implementation is to invest in a robust technology solutions that outline resource capabilities for storing, managing, and analyzing of both financial and clinical data aspects to accommodate best-practice, while reducing costs and improving operational outcomes. Nurse Executive’s Role in Bundle Strategy Innovation To meet the health care reform challenges, and assume the financial risk of a fixed payment regardless of cost the nurse executive will need competencies consistent with those found in AONE. The communication and relationship-building domain will support nurse executives to forecast future needs and impact of patient care can be determined through academic relationship building and emphasizes on effective communication with the care team (AONE, 2011). The role of knowledge of the health care environment domain addresses numerous measures to successfully facilitate the nurse leader’s knowledge in clinical practice, health care policy, informatics, case management, and quality improvement metrics needed to predict and deliver safe effective care coordination in the development of a bundled program (AONE, 2011). Furthermore, the AONE identifies that nurse executive will need to possess a nurturing leadership style that is in alignment and conducive to situational needs to develop and promote …show more content…
The professional domain provides the nurse executive with the ability to create an environment favorable to advocating for optimal health care in the community, while representing the viewpoint of patients and families in the patients care (AONE, 2011). The competencies provide the nurse executive with skills essential for being able to comprehend how to analyze a budget’s performance through the business skills domain, which permits the leader to better manage financial resources adequately. In addition, knowledge of technology platforms will be essential to the effectiveness of hospital operations. Nurse executives that possess excellent leadership and business skills, along with understanding the health care delivery system will have gained insight of future innovations needed to provide excellent quality of care while achieving favorable organizational
With bundled payments Medicare beneficiaries are offered a choice of what level of care they will receive regardless of physician orders. Hospitals offer a list of all participating providers within the patient’s service area, so that they can determine which provider they will use for their health care services. The hospital encourages the patients to seek better community service line areas out of the list providers that they have collaborated services to potentially enhance monetary gain. In order for the organization to achieve this goal educating patients who the higher quality providers are will be essential. To achieve these outcomes, an important part of the nurse executive’s role is to promote, and place focuses on methods the health care team can “reframe” their workflow to accomplish favorable patient outcomes (Dunham-Taylor & Pincszuk, 2010, p. 119). Information Technology for Bundled Payment An operational health information technology (IT) platform that links health care providers and permits them to actively manage patients is vital to the efficiency of any organizations pursuing to apply a bundle payment program (CMS, 2011). …show more content…
It will be important to generate reports that are necessary to classify at risk patients and compare organization’s performance to benchmarks. Reporting through information sharing through the electronic health record (EHR) and quality monitoring will be vital to ensure preferred provider practices and outcomes are in place for bundled payment participation. The key to an organization’s success in bundle implementation is to invest in a robust technology solutions that outline resource capabilities for storing, managing, and analyzing of both financial and clinical data aspects to accommodate best-practice, while reducing costs and improving operational outcomes. Nurse Executive’s Role in Bundle Strategy Innovation To meet the health care reform challenges, and assume the financial risk of a fixed payment regardless of cost the nurse executive will need competencies consistent with those found in AONE. The communication and relationship-building domain will support nurse executives to forecast future needs and impact of patient care can be determined through academic relationship building and emphasizes on effective communication with the care team (AONE, 2011). The role of knowledge of the health care environment domain addresses numerous measures to successfully facilitate the nurse leader’s knowledge in clinical practice, health care policy, informatics, case management, and quality improvement metrics needed to predict and deliver safe effective care coordination in the development of a bundled program (AONE, 2011). Furthermore, the AONE identifies that nurse executive will need to possess a nurturing leadership style that is in alignment and conducive to situational needs to develop and promote …show more content…
The professional domain provides the nurse executive with the ability to create an environment favorable to advocating for optimal health care in the community, while representing the viewpoint of patients and families in the patients care (AONE, 2011). The competencies provide the nurse executive with skills essential for being able to comprehend how to analyze a budget’s performance through the business skills domain, which permits the leader to better manage financial resources adequately. In addition, knowledge of technology platforms will be essential to the effectiveness of hospital operations. Nurse executives that possess excellent leadership and business skills, along with understanding the health care delivery system will have gained insight of future innovations needed to provide excellent quality of care while achieving favorable organizational