As healthcare continues to evolve and change, what are policy recommendations from state and national organizations on healthcare expenditures and reimbursement of services, in particularly for Nurse Practitioners?
As healthcare continues to evolve and change, what are policy recommendations from state and national organizations on healthcare expenditures and reimbursement of services, in particularly for Nurse Practitioners?
As healthcare continues to evolve and change what are policy recommendations from state and national organizations on healthcare expenditures and reimbursement of services in particularly for Nurse Practitioners
Discussion Question
Expenditures and reimbursement continue to define quality of healthcare for providers, consumers, researchers, and policymakers at both state and national levels. Many state and national organizations are keen on ensuring that the cost of healthcare remains affordable for all individuals that require care while healthcare providers like nurse practitioners get reimbursements based on value creation and quality and not quantity or volumes (Cleveland et al., 2019). The enactment of the Affordable Care Act and progressive expansion of Medicare and Medicaid programs are considered as some of the most fundamental changes or reforms in the sector focused on reducing expenditures while also streamlining reimbursements to nurse practitioners and other healthcare providers (Maddox et al., 2019). A host of policy recommendations at both state and national levels through legislations focus on expanding the role of nurse practitioners by increasing the scope of practice authority to ensure that more Americans access care. Policies at state level focus on expanding Medicaid and reform, the need to tackle high and rising provider and pharmaceutical costs and issues concerning value creation. According to Murray et al. (2019), state policymaking organizations continue to focus on price transparency, the benefit model, provider payment, and provider networks and market power. The implication is that nurse practitioners are at a strategic position to enhance quality while also reducing the cost of care.
Nurse practitioners should consider consumer costs associated with pharmacological therapies and diagnostic
NU 503 Assignment 1 Health Policy Brief Part I
testing because these are a core aspect of increased need for expansion for Medicare and Medicaid programs. The Centers for Medicare and Medicaid Services (CMS) is categorical that reimbursement to nurse practitioners and other health care professionals should be based on quality and value creation (Stadhouders et al., 2019). Therefore, nurse practitioners, especially in states with expanded practice authority should consider consumer costs to get their reimbursement from health insurance providers.
References
Cleveland, K.A., Motter, T., Smith, Y., (2019) “Affordable Care: Harnessing the Power
of Nurses” OJIN: The Online Journal of Issues in Nursing, 24(2). Manuscript 2. DOI: 10.3912/OJIN.Vol24No02Man02
Maddox, K. E. J., Bauchner, H., & Fontanarosa, P. B. (2019). US health policy—2020 and
beyond: introducing a new JAMA series. JAMA, 321(17), 1670-1672. doi:10.1001/jama.2019.3451
Murray, R., King, J. S., Delbanco, S. F. & Lehan, M. (2019). The State of State Legislation
Addressing Health Care Costs and Quality. Health Affairs. 10.1377/hblog20190820.483741
Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective healthcare
cost-containment policies: a systematic review. Health Policy, 123(1), 71-79. https://doi.org/10.1016/j.healthpol.2018.10.015