Discuss fiscal planning and cost containment financial factors that pertain to today’s professional
nursing roles in leadership Criteria:
Develop a scholarly paper that addresses the following criteria:
1. Discuss the budgetary process
a. Types of budgets
b. Budgeting measures
2. Discuss health-care reimbursement
a. Medicare and Medicaid
b. Prospective payment systems
c. Managed care
3. Include cost containment and the role of the nurse
a. Balancing cost and quality of care
4. Discuss Health-Care Reform and the Affordable Care Act
a. Bundled payments
b. Hospital Value-Based Purchasing
c. Health Insurance Marketplaces
5. The scholarly paper should
a. 4 to 5 pages, excluding the title and reference page.
b. Include an introductory paragraph, purpose statement, and a conclusion.
c. Include level 1 and 2 headings to organize the paper.
d. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To
clarify: I, we, you, me, our is not used. In addition, describing yourself as the researcher or the author should not
e. Include a minimum of three (2) peer-reviewed scholarly journal references to support the paper (review in Ulrich
Periodical Directory) and be less than five (5) years old.
f. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
Fiscal Planning and Cost Containment in Nursing Leadership
Fiscal planning and cost containment are increasingly important aspects of nursing leadership. As health care costs continue to rise, nurses are being called upon to play a more active role in managing resources. This paper will discuss the budgetary process, health-care reimbursement, cost containment, and the role of the nurse in leadership.
The budgetary process is a systematic approach to planning and controlling financial resources. It involves setting goals, developing plans, allocating resources, and monitoring performance. There are three main types of budgets: operating, capital, and cash.
Operating budgets are used to plan for the day-to-day expenses of an organization.
Capital budgets are used to plan for the purchase of long-term assets, such as buildings and equipment.
Cash budgets are used to track the flow of cash in and out of an organization.
The budgetary process is typically led by the finance department, but nurses can play a key role in developing and implementing budgets. Nurses have a unique understanding of the costs and resources associated with patient care, and they can use this knowledge to help ensure that budgets are realistic and achievable.
Health-care reimbursement is the process by which health care providers are paid for the services they provide. There are a variety of reimbursement methods, including fee-for-service, prospective payment systems, and managed care.
Fee-for-service is the traditional method of reimbursement. In this system, providers are paid a set fee for each service they provide.
Prospective payment systems are a type of reimbursement system in which providers are paid a predetermined amount for a specific service.
Managed care is a type of health insurance that uses a variety of methods to control costs, such as preauthorization, utilization review, and case management.
The type of reimbursement method used can have a significant impact on the cost of health care. For example, prospective payment systems have been shown to reduce costs by encouraging providers to be more efficient.
Cost containment is the process of reducing the cost of health care. There are a variety of cost containment strategies, including:
Efficiency: One way to reduce costs is to become more efficient. This can be done by reducing waste, streamlining processes, and using technology to improve efficiency.
Utilization management: Utilization management is the process of reviewing and approving health care services before they are provided. This helps to ensure that services are necessary and appropriate, and that they are not overused.
Case management: Case management is a process of coordinating care for a patient with complex needs. This can help to reduce costs by ensuring that patients receive the right care at the right time, and that they are not discharged from the hospital prematurely.
The Role of the Nurse in Cost Containment
Nurses play a key role in cost containment. They can help to reduce costs by:
Providing efficient and effective care: Nurses can use their knowledge and skills to provide care that is both high quality and cost-effective.
Managing resources wisely: Nurses can help to ensure that resources are used wisely by identifying and eliminating waste, and by advocating for the use of cost-effective practices.
Communicating with patients and families: Nurses can help to educate patients and families about the cost of health care, and about ways to reduce costs.
Health-Care Reform and the Affordable Care Act
Health-care reform is a broad term that refers to the changes that have been made to the health care system in recent years. The Affordable Care Act (ACA) is the most significant health-care reform law in recent history.
The ACA has a number of provisions that are designed to improve the quality and affordability of health care. These provisions include:
Expanding health insurance coverage: The ACA has expanded health insurance coverage to millions of Americans who were previously uninsured.
Providing subsidies to help people afford health insurance: The ACA provides subsidies to help people afford health insurance.
Requiring insurance companies to cover people with pre-existing conditions: The ACA requires insurance companies to cover people with pre-existing conditions.
Providing incentives for preventive care: The ACA provides incentives for preventive care, such as annual checkups and vaccinations.
The ACA has had a significant impact on the health care system. It has expanded health insurance coverage, reduced costs for some people, and improved the quality of care.
Fiscal planning and cost containment are increasingly important aspects of nursing leadership. Nurses can play a key role in managing resources and reducing costs. By working together, nurses, administrators, and other health care professionals can help to ensure that the health care system is both affordable and high