Healthcare Finances and Nursing: Let’s Get Fiscal!

By: Eileen P. Williamson, RN, MSN, Senior Vice President and Chief Nurse Executive at Nurse.com
Eileen Williamson, RN

Eileen Williamson, RN

During the past several decades we’ve seen nurses move into some of the highest levels of healthcare management, leadership and governance. Current CNOs have become vital members of executive leadership teams, and in C-suites all over the country there’s no question that “the nurse is in!”

CNOs and CEOs have formed strong, successful working relationships, and others on the leadership team, particularly CFOs, have become vital partners and allies of nursing. CFOs have to know the nursing department and its needs and resources, and CNOs must understand the finances of the larger organization. Healthcare is big business, and for nurses to be successful they must be as conversant with financial matters as they are with patient care. To maintain their seats at the decision-making table they need fiscal and clinical know-how; to provide patient care in an efficient, cost-effective, quality manner they need to be schooled in all things financial. And this applies to nurses at all levels; no matter where you are on your career path, it’s never too soon or too late to “get fiscal!”

These are turbulent times. Healthcare is facing challenges that couldn’t have been imagined when many of us began our careers. And a large number of those challenges can be financial. Government and regulatory agencies keep setting new standards and guidelines that we need to be conversant with. Healthcare legislation is being passed all the time, and we need to have a voice in it. Increasing demands are being placed on the healthcare system as dollars continue to decrease. And nurses, providers and patients are all being affected by national budgetary and spending cuts. Within nursing in particular, research and education are being hard hit. Care providers are facing decreased reimbursement rates. Some patients are finding they must decrease their utilization of services, while others are having problems accessing services, experiencing increased coverage denials or being faced with more stringent eligibility requirements. The finances of healthcare are more important than ever, and nursing is a critical part of them.

The good news, however, is that there is good news for nursing. First, rather than being viewed as a cost-center as it once was, nursing is now being seen as a cost-savings center and a driver of quality that can impact revenue. Second, insurance provisions that mandate denial of payment on readmissions for hospital-acquired conditions are putting nursing squarely in the driver’s seat when it comes to revenue: When nursing performs well, patients do well and the hospital gets paid. And third, the removal of barriers to APRN practice as recommended by the IOM Report will improve the bottom line. When APRNs practice more autonomously and patients receive care from them in non-hospital settings, the number of hospitalizations and readmissions decrease.

It’s an interesting time to be in healthcare and an important time to be a nurse. Its opportunities can make it the best of times; its challenges can make it the worst of times. We must stay tuned to news at the federal level, know about legislation and regulations at the state level and keep up with what’s happening in our profession and at our workplaces—it will all add up to better care for our patients.

We need to care about what care costs because finances really do count, and we all have to get fiscal!

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