Viewpoint: A new hospital funding model could help nursing shortage

There is ongoing dialogue about the nursing shortage in the U.S., but part of the conversation may be getting lost, says Olga Yakusheva, PhD, a professor at the University of Michigan School of Nursing in Ann Arbor.

Dr. Yakusheva, along with Robert Longyear, CEO of Avenue Health, a healthcare service company, argue that what healthcare needs is a new hospital funding model. According to their collaborative research, which was published May 20 in Health Affairs, "unbundling" nursing care from hospital care and treating it separately in government reimbursement models. 

"When we need legal advice, we pay a lawyer; when we see a doctor, the doctor sends us the bill," Dr. Yakusheva said in a University of Michigan Q&A shared with Becker's. "But when we need bedside nursing care, instead of consumers paying nurses directly, hospitals bundle these costs in with other expenses in the hospital bill — sheets, food, cafeteria workers, etc." 

Instead, Dr. Yakusheva says billing for nursing separately would create an incentive for hospitals to invest in more sustainable levels of nursing staff, but it would mean a higher price tag.

"Our model unbundles nursing care from the hospital charge and pays for it separately. This way, hospitals that invest in sustainable levels of nurse staffing and a safe environment can charge more for nursing care," she said during the Q&A. "Hospitals that understaff and underinvest in their nurses get paid less, and can no longer put that money toward other uses. This eliminates the opportunity for hospitals to earn a short-term financial gain by cutting nursing jobs or spending." 

Separating the nurse payment from a facility general payment could also make it easier to see how much the nurses earn and establish "transparency and accountability for resource allocation toward nursing care that patients and families need," she said.

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