Introduction:
US healthcare organizations operate in an environment that is highly regulated yet very accountable for the care provided. This extends to the financing involved in providing healthcare services. The purpose of this module is to acquaint us with both healthcare costs and the respective reimbursements.
Comparing Reimbursements with Costs:
Objectives: At the end of this class session you will be able to:
1. Determine if the reimbursement given is enough to cover the costs of the service provided
2. Apply the four distinct cost determination methods
3. Describe how to determine the cost of care in a nursing area or unit.
4. Identify the differences between a volume based and a value based environment.
Required Readings:
Legler, M. J. & Dunham-Taylor, J. (2018). Financial Management for Nurse Managers: Merging
the Heart with the dollar. Jones-Bartlett, Burlington. Ma.
Chapter 8: Comparing Reimbursements with Costs of Services Provided, Pgs. 173-194.
Activities for this Class Session:
1. Complete the assigned readings for this class period.
2. Complete the Discussion Forum as described below.
Discussion Forum Assignment:
1. Nursing services has traditionally not been considered a revenue generator. This has both positive and negative aspects. List three positive and three negative aspects that you can think of this idea.
2. This chapter covered a lot of information that makes us think about the cost of providing patient care services. What part of this information did you find the most helpful and what part do you need additional sources for the make sense?
3. What is the major difference reimbursement between a volume based and a value based environment.
Due Dates: See Course Calendar for due dates
Point totals for this activity: See Section II explanation for Graded Activities.
AACN Baccalaureate Essential Outcomes included in this module:
2.3 Demonstrate an awareness of complex organizational systems.
2.11 Employ principles of quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system-wide practice improvements that will improve the quality of healthcare delivery.