Because of the complexity of reimbursement systems and its implication

QUESTION

Because of the complexity of reimbursement systems and its implications for the services available to patients, the nurse has a key role in:

a. Advocacy for patients with regard to services required and services utilized.
b. Increasing the volume of services and decreasing the number of patients served.
c. Accomplishing more with each visit and decreasing the volume of services used.
d. Decreasing the volume of services used and the number of return visits.

ANSWER:

ANS: A
The specific strategies employed by organizations and nurses to contain costs and increase revenues depend on the reimbursement system(s) within which the organization operates and therefore on whether the volume of services is increased or whether the volume of services is decreased by placing greater emphasis on efficacy in each visit and reducing the number of return visits. Because of the complexity of the reimbursement environment, the nurse is placed in a position of advocacy in terms of what the patient needs and how those needs can be best met within the funding structures.