The Advanced Practice Registered Nurse reimbursement history started in 1990. Medicare provided it only in some rural parts of the country and skilled medical institutions. In a few years, the American Nurse Association proved that nurses did not earn enough, but the quality of their work was usually high. Thus, the reimbursement became available for Nurse Practitioners and Clinical Nurse Specialists, and Nurse Practitioners. Its amount was not more than 85% of the physician’s rate. To afford these expenses, the government created specialized organizations which keep helping APRNs now.
Reimbursement has a positive effect on my nursing practice. Undoubtedly, with its presence, my responsibility increased. The work must be done efficiently; other areas of influence appear, for instance, management, the policy of the medical institution, and reporting. However, motivation in the form of reimbursement made these tasks exciting and challenging. It allows me to bring the quality of my work to a new level.
My organization offers various payor types to its patients. First of all, we cooperate with different insurance companies and keep patients informed about them. Thanks to this, medical care can be provided to patients with various insurance policies, which increases the number of visitors. We always try to tell patients about the cost of all services fully, so they can be calm about their choice and receive treatment within the framework of an excellent price-quality ratio. In this case, the hospital gets satisfied regular customers, which positively affects its functioning.
Although reimbursement is a significant positive development, some changes to the system could have a positive effect on APRNs. Researchers state that “every ARPN has an ethical and moral obligation (the social contract) to influence both public and health policy so that the health of the public is both protected and promoted” (Joel, 2018, p. 160). It is clear that such strict rules are essential to control the process. However, the system of payment for a particular job is quite complicated and does not always benefit nurses. For example, a pouching procedure or a problematic dressing change are not paid for by Medicare, although these are common activities. Also, the process of calculating and receiving reimbursement itself is excessively long and involves a large number of documents. Thus, simplifying the system could be helpful, productive, and even motivating.
Value-Based Insurance Design is also one of the significant phenomena in today’s medical practice. As part of the VBID, the price of the most critical and necessary treatment is reduced. This makes it possible to save money on potential costs in the future if more expensive medicines or operations are needed. In addition, it has a positive effect on the clinical outcome since essential examinations and simple procedures are becoming much more affordable. This allows people to diagnose some diseases at the earliest stages and prevent their future development. Thus, VBID is profitable for both patients and medical organizations.
Medicine is one of the areas in which it is difficult to find a rational approach to the distribution of funds. Many people do not always have enough money for treatment, while doctors and nurses deserve high payment. To improve the situation and encourage medical personnel, the government has created various programs, in particular, the system of reimbursement for APRNs. Also, a wide range of insurance types for patients has a positive effect on the medical sector. These factors are significant for the medical system’s development and are beneficial for the whole society.
Reference
Joel, L. A. (2018). Advanced practice nursing: Essentials for role development. F. A. Davis Company.