Patient Care Impact on Budget
April 21, 2015
Patient Care Impact on Budget
As healthcare evolved many years ago, so did the rising costs of providing it and this is how a need for insurance coverage arose in order to offset some of the expenses. Nurses today have greater accountability for an organization’s financial success. The hospital I work for is an acute inpatient rehabilitation facility. One issue that affects the position I work in is that of the large number of patients that do not have healthcare insurance but need to be admitted to our hospital.
Many times, the patients that come to us are young people in catastrophic accidents who end up with spinal cord injuries or traumatic brain injuries and have no health insurance. These patients must be treated so turning them away is not an option. In my job, I have to write up the clinical information about a patient, assess the patient and speak to their families to assess their condition and their appropriateness for admission. This information, in addition to having a viable discharge home plan and the verbalization of readiness for rehab, is presented to a team of senior executives who make a determination on whether or not to accept a patient who has no insurance. Journal of Neuroscience
A new model for predicting recovery after spinal cord injury is based on motor scores at admission and early diagnostic imaging studies and may allow clinicians to predict functional outcomes and guide decision-making for therapy and caregiving needs. This model combines acute functional measures and evidence of injury on MRI to help guide treatment decisions, classification for clinical trials and patient counseling (Liebert, 2012). This is an interesting model that can be utilized to predict potential recovery which can help an organization determine the feasibility of taking in a patient on charity (Liebert, 2012). Missouri Foundation for Health
Charity care consists of free or discounted health and health-related services to people who can’t afford to pay for healthcare to uninsured low income patients. Unreimbursed care consists of charity care plus shortfalls and contractual allowances from Medicare and Medicaid. In 1969, the IRS established a community benefit standard requiring non-profits to deliver health care in a way that benefits their community in exchange for a federal tax exemption. Unfortunately, hospitals treating a large share of low income and Medicaid patients incur higher operating costs. Medicaid federal and state DSH programs require hospitals to provide charity care to people meeting certain criteria. The state of Missouri makes payments to hospitals above what it reimburses other providers for Medicaid services. These payments go to hospitals that provide care for a large number of Medicaid patients. Many hospitals are taking measures to protect their tax-exempt status and address growing number of uninsured or underinsured persons (MSF, 2005). Despite changes that began in the year 2010, i.e. The Affordable Care Act, the prediction is that approximately 20 million people will still be uninsured. Reform will present significant changes for charity care programs and this will necessitate the task of assessing and meeting the needs of the remaining number of uninsured people (Chazin, 2010). Nurses Role
Nurses today have a direct responsibility to provide quality healthcare while being conscious of financial concerns. This can be done by being conscious of using unnecessary supplies, wasting medications, streamlining work processes, being advocates in assisting patients to find resources, and beginning discharge planning upon admission.
References Chazin, S. et al. (2010). The Future of U.S. Charity Care Programs: Implications of Health Reform. Retrieved from: www://thefutureofuschairitycareprograms:implications-of-health-reform....
References: Chazin, S. et al. (2010). The Future of U.S. Charity Care Programs: Implications of Health Reform. Retrieved from: www://thefutureofuschairitycareprograms:implications-of-health-reform.
Liebert, Mary Ann (2012, August 8) New Model for Predicting Recovery After Spinal
Cord Injury, Journal of Neurotrauma (29)11 Retrieved from
Missouri Foundation for Health (2005) Hospital Charity Care in the United States
Retrieved from website www.mffh.org/mm/files/HospitalCharityCare.IssueBrief.pdf.
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