How competing needs may impact the development of polices to address that issue 

How competing needs may impact the development of polices to address that issue 

For years the healthcare system in the United States has relied on a fee-for-service payment system whereby each medical service and procedure is paid for separately. However, this payment model created several limitations, including fueling health care costs, overtreatment, and overutilization at the same time leaving others underserved and undertreated. In an attempt to counter these perverse incentives, the legislation of payment reforms which focuses on methods that reflect providers’ performances, primarily quality, safety, and patient experience, has been put in place to replace the traditional system of fee-for-service (Palumbo et al., 2017). The new healthcare payment reform has been designed to spur provider efficiency, reducing unnecessary spending subsequently reducing healthcare costs. However, competing needs such as the use of 12-hour shifts as employees’ retention strategy, workforce, and resources have affected the development and adoption of this critical policy following the necessity that surrounds competing needs to align with the agenda of payment reform.  

Payment reforms such as Medicare, which pushes for bundled payment, whereby patients are required to use only one payment method covering all episodes of care, have to address nursing shortages. With the aging population steadily rising, Medicaid has been burdened with being the primary payer of healthcare for many Americans. Nurses play a critical role in driving system change because of their sheer numbers (Miller et al., 2017). It is estimated that as of 2019, over 3.8 million registered nurses were integrated into the American workforce, a lower number compared to the health care needs of the American people. As a result, the available nursing workforce is forced to register more hours in their workplaces, reducing quality, safety, and quantity of care service (Rivers & Glover, 2008). There are numerous severe ramifications associated with shortages of nurses, such as work overload of available healthcare personnel, which results in burnout and subsequently compromise patient safety and long waiting, which may cause more harm, including preventable deaths.  

References: 

Miller, B., Ross, K., Davis, M., Melek, S., Kathol, R., & Gordon, P. (2017). Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care. American Psychologist, 72(1), 55-68. https://doi.org/10.1037/a0040448 

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation?. Journal Of Professional Nursing, 33(6), 400-404. https://doi.org/10.1016/j.profnurs.2016.11.005