By on Dec 30, 2014 in Leadership, News, NNBA, Nurse Entrepreneurs, Success Tips

Health Leaders Top Stories of 2014 and What It Means for Nurses

According to Health Leaders Media, the following are 3 stories of 2014 that are causing controversy and will impact how health care is delivered. I’ve summarized these stories and how I believe it will impact the nursing profession. If you would like to read the articles in their entirety, just click on the topic’s title. I’d love to hear your opinion on these top stories so make sure to send in your comments!

Two-Midnight Rule Will Cost Hospitals Big

Basically, this one says that there’s a proposed rule that doctors, with the help of any decision-making staff to decide whether a patient is likely to need to stay in the hospital that extends over to midnights. This will determine essentially the patients billing status as designated inpatient or outpatient and this makes a big difference to reimbursement. The simple demarcation between inpatient and outpatient status prodded by Medicare’s proposed rule has the potential to turn into a big revenue problem. But good documentation can help.

What’s that mean for nurses?
Nurses will be doing more charting and even less time with direct patient care. The negative aspects also provide positive opportunities for nurses. CNO’s need to proactively determine what nursing staff’s involvement will be with charting this information. Advance forms that could be used from the ER and Observation Rooms prior to possible admissions would stream line information and not cause impromptu and last minute contribution from the nursing staff. Also, an understanding of the rules governing reimbursement should be shared and reviewed with the health care professionals working in the emergency and observation departments so that proactive measures can be taken.

Doctor Shortage ‘Fix’ Is a Disaster Waiting to Happen

Dr. Shortage Fix is a disaster waiting to happen. New legislation in Missouri will create a new class of medical license, the “assistant physician”. Critics say it will establish a reprehensible dual standard of care, one for the rural and underserved and another for everyone else. This new type of certificate would be handed out to medical school graduates who didn’t get into a residency program and who passed Step 1 and 2 exams, but not the most important one, Step 3.

With minimal prior exposure to patients, these young doctors would be licensed to practice just like regular doctors, as long as they only treated patients in the most physician-starved poor and rural areas throughout the state.

What’s that mean for nurses?
Nurse Practitioners are up in arms about this one and rightly so. Currently, Missourians are not able to take advantage of available nurse practitioners. Missouri is the 44th most restrictive state for nurse practitioners. 18 states now permit nurse practitioners to practice without any physician oversight. Missouri, however, requires them to work with physicians in a collaborative practice.

The Hospital of the Future is Not a Hospital

As it turns out, the hospital of the future doesn’t look much like a hospital at all. Instead, it’s a cohesive amalgamation of plenty of outpatient modalities that represent growth in healthcare. Inpatient care, increasingly, represents stagnation and shrinkage, in the business sense.

In a recent survey on healthcare design trends conducted by Minneapolis-based Mortenson Construction, 95% of the healthcare organizations surveyed said most of the projects they are undertaking are predominantly ambulatory in nature. “If, in theory, the [Patient Protection and Affordable Care Act] has now got 7 million people engaged in healthcare insurance who didn’t have that previously, the inrush of patients will be outpatient-based,” says Larry Arndt, general manager of healthcare in the company’s Chicago offices. “What’s not needed is bed space or heavy procedural space.”

What’s that mean for nurses?
As money flows out of the traditional hospital setting so too will be money for nursing staff. Always the front line taking the budgetary hits; nursing departments will be required to let staff go. Having patients now in more ambulatory type settings further gives Administrators the ability to hire more health care technicians and aides versus registered nurses. Now more than ever nurses need to look at options of how to use their license independently and creatively. New opportunities in home health and transitional care will exist. Education to assist caregivers and health information technology as more health mobile apps will come on the market.

Health Care is big business and today’s nurses need to be aware of the rapid changes taking place. For over a generation, the NNBA has supported and encouraged nurses with transitioning to new business opportunities providing education and connection with other nurses in business. Many more opportunities and changes will occur as the PPACA rollout affects where and how money is reimbursed.

© Michelle Podlesni, NNBA, Bloom Service Group, Inc. 2014 All Rights Reserved

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