Literature Review On Financial Management In Healthcare ✓ Solved

Literature Review on Financial Management in Healthcare

The volatility around U.S health care policy and effects on financial management requires that nurse leaders have the motivation and knowledge to independently evaluate the current national environment and determine its relevance at the local level. Because your fiscal responsibilities could involve any number of care delivery systems, this assignment is designed to encourage you to further explore a financial management concept of interest to you. From your reading, identify a specific health care policy topic that affects health care delivery financing in your area of interest.

Be sure to narrow down the topic you address. For example, if you want to consider Medicare’s Service Benefit Plan, you might select one of the prospective payment mechanisms. Conduct a literature search on this topic and select 5-7 current, relevant, scholarly articles to review. Carefully review these articles and compare them to the information you have learned from your assigned reading.

Outline your paper as follows: Financial Management Concept Identify and briefly describe the financial management concept and your reason for selecting it. Comparative Analysis Write a comparative analysis of the articles by evaluating each and determining the current state of the art or what is collectively known and not known about the topic from the recent literature you have collected. Avoid simply reviewing each article and providing summaries; rather, seek to understand what the corpus of literature indicates now and write about that in your own words highlighting main themes.

Role Application Finally, describe how you would apply what you have learned through this literature review to your current or anticipated nursing leadership role in the future. Identify what questions your review has raised that you would like to investigate further. Because this is a shortened version of the standard Review of Literature, the paper should be 5-7 pages in length (not counting the title page and reference section) and presented in APA format. Title page should include student name, the financial management concept reviewed, course title, semester, and professor’s name. The bulk of your paper should be in the Analysis section.

Paper For Above Instructions

Title: The Financial Management of Medicare: A Comparative Analysis

The dynamic nature of healthcare policy in the United States prompts continual evaluation by healthcare professionals, particularly nurse leaders, who are at the forefront of ensuring effective care delivery within their communities. As nurse leaders navigate this challenging landscape, one financial management concept that stands out is Medicare's prospective payment system (PPS). The PPS significantly affects the operational and financial management of healthcare facilities, including nursing homes, hospitals, and outpatient facilities (Kahn et al., 2019). Therefore, this literature review aims to explore this concept in detail while examining how it influences financial management in healthcare delivery.

Financial Management Concept

The prospective payment system (PPS) is a method of reimbursement that uses pre-established rates to pay healthcare providers for specific services rendered to Medicare beneficiaries. Introduced in the early 1980s, PPS was designed to control costs and increase efficiency by providing fixed payments based on diagnosis-related groups (DRGs) (Harrington et al., 2020). This system encourages hospitals to minimize their length of stay and manage resources efficiently as payments are predetermined.

Motivated by personal interest in how policies affect nursing home operations, I selected PPS as the financial management concept for this literature review. Understanding its implications can provide nurse leaders with the tools to adapt and respond to evolving budgetary constraints and care demands.

Comparative Analysis

A literature search was conducted, yielding several scholarly articles discussing the impact of PPS on healthcare financial management. A key thematic concern across the literature is the balance between cost control and quality of care. For example, a study by Chen et al. (2021) emphasizes that while PPS helps control costs, it may inadvertently lead to reduced care quality if providers focus heavily on financial metrics without addressing patient outcomes.

Another article by Wu et al. (2020) explores the implications of PPS on nursing homes, revealing that facilities more heavily reliant on Medicare payments have faced financial stress due to the capped payment structure. This issue is compounded by the ongoing uncertainties in healthcare policy, as regulatory changes can significantly alter reimbursement rates and compliance requirements (Wong et al., 2019).

Moreover, research by Allen et al. (2022) highlights the geographical disparities in how PPS affects healthcare facilities. Facilities in rural areas may struggle more due to limited access to supplemental funding sources compared to urban counterparts. This disparity raises critical questions about equity in healthcare delivery and the potential for systemic inequalities to widen under current funding models.

In contrast, a more optimistic viewpoint is presented by Nytko and Magusiak (2023), who argue that PPS has spurred innovation in care delivery models. By forcing providers to prioritize efficiency, some institutions have adopted home health services and telehealth, ultimately expanding access to care while managing costs effectively.

Collectively, these articles illustrate the complexities associated with the prospective payment system. Understanding the current “state of the art” requires synthesizing these viewpoints and acknowledging that while PPS promotes financial sustainability, it must be continuously evaluated against the backdrop of quality care to ensure favorable patient outcomes.

Role Application

The insights garnered from this literature review will be instrumental in shaping my approach to nursing leadership. Specifically, understanding the nuances of PPS will prepare me to advocate for policies that balance cost control with quality care in my future practice. This knowledge positions me to engage with stakeholders, empowering me to communicate the implications of PPS on resource allocation and staffing decisions within healthcare facilities.

Additionally, this examination has raised questions warranting further investigation: How do healthcare disparities manifest within the context of Medicare's PPS? Moreover, how can technology innovations bridge gaps in care quality and access stemming from financial constraints?

By addressing these inquiries, I hope to contribute to a deeper understanding of financial management in nursing practice and advocate for equitable healthcare solutions in the future.

References

• Allen, J., et al. (2022). Financial stress in rural nursing homes under Medicare's prospective payment system. Journal of Rural Health, 38(1), 45-54.
• Chen, L., et al. (2021). Quality of care in Medicare fee-for-service versus Medicare Advantage. Health Affairs, 40(8), 1232-1239.
• Harrington, C., et al. (2020). The impact of reimbursement changes on nursing home quality. Health Services Research, 55(3), 412-424.
• Kahn, C., et al. (2019). Evaluating the impact of Medicare cost containment policies. American Journal of Managed Care, 25(6), 263-272.
• Nytko, J., & Magusiak, R. (2023). Innovations in care under the prospective payment system: A new dawn for patient care? Journal of Healthcare Management, 68(4), 300-310.
• Wong, J., et al. (2019). Navigating policy changes in Medicare reimbursement: Challenges for healthcare providers. Public Health Reports, 134(6), 651-657.
• Wu, J., et al. (2020). Medicare payment reform and nursing home care quality: A systematic review. Journal of Aging & Social Policy, 32(2), 135-152.