While doctors supervise care delivery, nurses have the most patient-facing time during an episode of care. In these roles, nurses hold many responsibilities which impact outcomes, and the total cost of care. With the healthcare payment landscape shifting from fee-for-service to value-based care, the role nurses play can make-or-break value-based payment models through their staffing, ability to impact patient satisfaction, and their clinical effectiveness. Due to these responsibilities, your nursing staff is an important variable that impacts your bottom line.
Here are 7 ways that nurses help drive your bottom line.
- Appropriate Staffing Levels Keep Patients Safe & The Cost of Care Low
Nurse-to-patient ratios have shown to be an indicator of patient safety. When there are fewer patients per nurse, patients are safer by providing more personalized care, more attention, and time with each patient. The result of patients having increased interaction with nurses is better health outcomes and a lower cost of care.
On the flip side, when facilities have fewer nursing staff, staff work overtime, increasing costs to the employer and decreasing profit margins. Nurses working overtime are more prone to human errors during care, negatively impacting patient outcomes, and negatively impacting the bottom line.
- High cost of turnover
Nurse-to-patient ratios impact nurse satisfaction as well. When nurses have fewer patients under their direct care, they are less rushed and can do their jobs well. As a result, nurses in these environments are more satisfied with their jobs, and turnover decreases. Turnover represents a massive cost to facilities. In 2021, the average nurse turnover costs its employer approximately $40,000[1]. It is much more cost-effective to the staff at capacity, or slightly overstaffed than risk the cost of nurse dissatisfaction and the associated downstream turnover.
- Patient satisfaction tied to reimbursement
According to Gallup poll data, Nurses have been the #1 most trusted professional - across all professionals - since 1999[2]. Nurses have the most interactions with patients and thus have time to build trust and develop strong patient relationships. This impact creates a positive patient experience, which is tied to reimbursement. With the momentum of value-based care, patient satisfaction is a metric that is being increasingly tied to reimbursements[3].
- Case Management
Historically, nurses are a key stakeholder in case management roles, assisting in care coordination, transitions of care, and denial and pre-authorization management, which directly impacts the bottom line. With insurers increasing prior authorization requirements and denying increased amounts of claims, your nurse case managers must be effective in navigating changing insurance benefits to deliver patient care at the right time and ensure that the prerequisites are completed for reimbursement.
- Readmissions
An increase in nurses is correlated with better patient care outcomes. When patients have more attention from nurses, their outcomes improve. One indicator of this is reduced inpatient readmission rates. Recent emphasis has been placed on this from payers in the shift to value-based care as payers place costly penalties on providers that have high readmission rates[4]. Facilities employing more nurses in direct patient care will likely see lower readmission rates, higher profit margins, and will avoid the associated penalties from insurers.
- Shift to managed care contracts
Across the nation, state Medicaid programs are increasingly working with managed care companies to deliver managed care long-term services and support (MLTSS) in long-term care (LTC) facilities. LTC managed care contracts provide value-based incentives for high-quality, low-cost care to decrease end-of-life spending and deliver budget predictability back to state Medicaid payers. There is recent momentum with state Medicaid programs to adopt this payment model. As of year-end 2020, 25 states contracted with LTC facilities through managed care contracts, as opposed to 8 states in 2004[5]. To be successful in managed care contracts, facilities should consider furthering their investment in nursing staff to increase the quality of care and decrease costs to ensure profitability.
- Revenue Generating Nurses
While the nursing roles previously mentioned largely impact cost savings associated with patient care, advanced practice nurses, or nurse practitioners, serve as billing providers that can increase revenue. The average rate for a nurse practitioner is less than half of their physician counterpart, and depending on the insurance contract, can bill at a similar or identical rate. This presents opportunities for facilities to employ nurse practitioners in roles appropriate to their scope of practice, and reallocate physicians to the higher acuity patient cases. Nurse practitioner graduates are currently outpacing the rate of primary care physician graduates, providing an alternative billable staffing resource with higher profit margins.
By maintaining appropriate staffing levels and empowering nurses to practice at the top of their licenses, nurses on the frontlines of patient care can make decisions to impact readmissions, case management decisions, patient satisfaction, and improve reimbursement in value-based payer contracts, improving outcomes and your bottom line. WeCare started as an idea to create a better healthcare experience for those in need, it is the core of our foundation and what inspires us to keep growing. This is why at weCare we focus not only on the quality of our nurses, but the quality of care they provide day in and day out. Choose weCare for your medical staffing needs.
[1] 2021 NSI National Health Care Retention & RN Staffing Report
[2] Nurses Ranked Most Trusted Profession 19 Years in a Row
[3] DON'T LET NURSES SINK YOUR BOTTOM LINE
[4] Nursing shortage puts patient health – and the hospital’s bottom line – at risk
