Reimbursement isn't a priority for nurses — Here's why the ANA is still focused on it

Reimbursement alone isn't among nurses' top priorities. However, a lack of transparency in nurse reimbursement is a contributing factor to many of the top issues they do want addressed, such as workplace violence and inadequate staffing. 

To get a pulse on what nurses want prioritized when it comes to policy, the American Nurses Association recently surveyed all of its members. Reimbursement scored fairly low in comparison to issues related to the work environment, like staffing and workplace violence, Tim Nanof, the ANA's vice president of policy and government affairs, told Becker's.

However, "the reimbursement structure is an underlying pressure point that makes it harder to affect change when it comes to things like workplace violence, staffing, and mandatory overtime," he said. "If we were to improve that reimbursement structure, it gives us more flexibility in addressing those other challenges." 

As such, improving transparency in nurse reimbursement is at the top of the ANA's advocacy agenda this year. Specifically, the group plans to work with CMS on a method that would involve reporting nursing payments as a separate line item when hospitals are reimbursed through diagnostic-related group payments. 

"That [DRG] structure is where we have a lack of transparency, which is our first ask — to make it a little clearer what the nursing portion of that payment is," Mr. Nanof said. "While there is a nursing payment, it gets factored into the overall hospital payment … so it makes it a little unclear when we are asking hospitals to use their full allowance on nursing care. What does that really mean?" 

Later this month, the ANA is holding a summit to gather more details about what a method to increase transparency of nurse reimbursement would look like. The organization hasn't yet had direct conversations with hospitals about the proposal, but plans to do so after the working meeting. 

"One of the big questions is how does our proposal directly impact the reimbursement that's coming into hospitals," Mr. Nanof said. "And our hope is first, it increases transparency, and second of all, that it increases resources that are available to hospitals."

Ultimately, the core purpose behind the reimbursement proposal is to increase the level of resources that are allocated to supporting nursing staff. 

"Nurses are asking for more resources so they can do a better job and have more nurses on site to help share the workload," Mr. Nanof said. "Of course, everyone would like to see a salary increase, but that is not the driving factor. It's about additional resources that will benefit patients in the hospital and nurses in terms of their work environment." 

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