Article Review


Article Review













Article Review

Buerhaus in the article, Healthcare payment reform: Implications for nurses that featured in the Nursing Economics journal in 2010 provides that there is a growing need to alter the expenditure in public health in the United States. According to the author, the legislators on the United States have focused largely on reduction of the massive Medicare payments made to hospitals and physicians as a means of reducing the overall federal expenditure on healthcare. The changes within the fiscal policies in the country have also added to the pressures of reducing expenditures in healthcare through reforms.

Essentially, the federal budget deficits have grown significantly over the years given that the government has been driven to borrow funds as a means of sustaining the various social programs around the country. Paying off the federal debt is a priority for the government, which means that fewer funds are availed to government-administered programs such as healthcare. Such pressures are the source of force towards the need for healthcare reform resulting in decreased costs healthcare among healthcare providers (Buerhaus, 2010).

The article provides that some of the mechanisms of controlling healthcare expenditure would include alteration of the modes of payment to the healthcare providers and physicians. Such alterations in the payment systems would result in high levels of efficiency with minimal inequity towards providers and jeopardy towards the quality of care provided to patients in American hospitals. Nursing practitioners form the largest workforce in American healthcare institutions, which means that they account for the highest labor costs in American healthcare institutions. In addition, any form of changes in the modes of payment would mean that nursing professions would be the most affected labor segment in American healthcare institutions (Buerhaus, 2010).

The article focuses on the proposed payment reforms and the overall effects of such on the largest labor segment in American healthcare-nursing professionals. An interview in the article with John Welton demonstrates the importance of the existing hospital payment system that gives high recognition of the role of nurses in American hospitals. The interview is essential in that it provides an overall view of the existing hospital payment system and some of proposals towards rectification of the drawbacks of the payment system. The interview notes that the efforts of nurses are not provided with direct appreciation. This results in high levels of inequality in the form of nursing workload because of increase in patient acuity. In addition, the room rates are not reflective of the additional care that is provided to patients as a necessity (Buerhaus, 2010).

Welton provides that the there is a need to remedy the existing payment mechanisms given that they do not provide incentives to the existing nursing population in American hospitals. The existing payment system provides higher revenues for hospitals in relation to high patient-to-nurse ratios. Proposed changes would provide reasonable payments to nursing professionals and other healthcare workers in relation to the variability of care provided to patients. Eliminating the fixed rates would ensure that the payments are made in relation to daily room charges or diagnosis related group (DRG) payments (Buerhaus, 2010).

From the article it is evident that the existing payment system is highly flawed necessitating the need for new strategies towards providing nursing professionals and other healthcare workers. The current system is ineffective given that it only provides for average costs of nursing for all the patients within the hospital irrespective of the diagnosis or DRG. The proposed system would provide incentives towards providing the patients with the highest level of quality care. This would result in transformation of the healthcare system in the United States. This is because the exiting system only provides for average rates that result in nursing work overload (Buerhaus, 2010).























Buerhaus, P. I. (2010). Healthcare payment reform: Implications for nurses. Nursing Economics, 28(1), 49–54.

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