Health Care Finance, Economics, and Policy for Nurses

A Foundational Guide

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Health Care Finance, Economics, and Policy for Nurses

A Foundational Guide

Third Edition

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Author

Betty Rambur, PhD, RN, FAAN

Description

Delivers knowledge to support a lifetime of informed, impactful advocacy

This concise, practical text---written for all nursing roles and levels of experience--synthesizes the complexities of health economics, finance, payment, ethics, and civic responsibility into an easy-to-understand, non-partisan guide to health policy and activism. It is distinguished from similar texts by its discussion of economic and financial dynamics in health care as a precursor to policy and advocacy in nursing. In addition to being revised and updated, the book includes substantially expanded material on artificial intelligence and large language platforms; information, quality, safety and costs; health equity; civics; laws, administrative rules and Supreme Court decisions; nurses on boards; Medicare Advantage and Part D, outpatient pharmaceuticals; the impact of mergers and acquisitions on nurses' salaries and career opportunities; and an entirely new chapter on the nursing workforce.

Written by a health economics and policy expert, dean, and award-winning teacher recognized as a "policy luminary" by the American Association of Colleges of Nursing, the resource discusses in depth the relationship between nursing and health care economics. It traces the history of our health care system from the early 1900s through today and discusses the intersection of ethics and economics to provide nurses with the tools to thoughtfully analyze dilemmas arising from today's focus on the bottom line. Using a step-by-step skill-building guide, the book describes--with the support of illustrative case--how to use economic principles to shape organizations and public policy. It breaks down complex financial principles to facilitate understanding for nurses with no prior knowledge of this discipline. Also included is updated information on the Patient Protection and Affordable Care Act and key subsequent legislation and Supreme Court decisions. Additionally, the book is compatible with online teaching and coursework. Faculty resources include PowerPoint slides, a test bank, comprehensive review questions and sample syllabi. Purchase includes online access via most mobile devices or computers.

New to the Third Edition:

Chapter 14: The Health Care Workforce: What Nurses Need to Know
Incorporates emerging innovations including social media applications, The Internet of Health Things (IoHT), and artificial intelligence
Addresses reimbursement and payment reform, links to upstream social determinants of health and health equity, and value-informed nursing practice
Discusses mergers, acquisitions and nurses' career opportunities and income
Provides up-to-date information on private equity's growing footprint, and how it effects nursing practice

Key Features:

Distills complex concepts into easy-to-understand information
Addresses systems-based practice domain of AACN Essentials
Provides engaging case examples for all nursing roles and levels of experience
Authored by a leading nurse expert, policy leader, former dean, and award-winning instructor
Guides readers in using economic principles to shape organizations and public policy
Provides chapter quizzes, PowerPoint slides, test bank, comprehensive review questions, and sample syllabi

Contents

A Note from the Author

How to Use This Text: A Note to Faculty

Acknowledgements

Springer Publishing Resources

Section I: The Context of Health Care in the U.S.

Chapter 1: How the Money Works: Nurses, Economics, Finance, and Reimbursement

Chapter 2: A Story of Unintended Consequences: How Economic and Policy Solutions Create New Challenges

Chapter 3: Navigating the Health Care Landscape Shaped by the Patient Protection and Affordable Care Act of 2010 and Subsequent Federal Legislation

Chapter 4: Payment Reform: Improving Care Delivery by Changing Who is Reimbursed, How, and For What

Section II: Health Care Economics: A Pragmatic Overview

Chapter 5: How Health Care Markets Differ from Other Markets...and Why it Matters

Chapter 6: Health Care Outcomes, Cost, Safety, and Value: The Critical Role of Information in Health Care Markets, Decision-Making, and Payments

Chapter 7: Market Entry, Exit, and Antitrust Law – Why it Matters to Nurses

Section III: Ethics and Economics in an Age of Reform: Demographic Shifts, Political Tensions, and Recognition of Increasingly Scarce Resources

Chapter 8: What is Ethinomics?

Chapter 9: Models to Guide Ethical Decision-Making

Section IV: Pulling it All Together: Using Your Knowledge of Health Care Finance, Economics, and Ethics to Improve Health and Health Care

Chapter 10: Governance and Organizational Type

Chapter 11: Building Skills for Board Membership

Chapter 12: Applying Health Economics to Improve Health Care through Federal and State Policy Formation

Chapter 13: Lessons from the COVID-19 Pandemic and a Look to the Future

Chapter 14: The Health Care Workforce: What Nurses Need to Know

Section V: Epilogue

Chapter 15: Living and Leading in a Changing World

Appendix A: Medicare Eligibility

Appendix B: Key Concepts in Health Finance, Economics, Policy, and Ethics: Level Setting Pre-Survey

Appendix C: The Policy Analysis Process

Index

Authors

Betty Rambur, PhD, RN, FAAN, is the Routhier Endowed Chair for Practice and professor of nursing at the University of Rhode Island. She was formerly professor of nursing and health policy and at the University of Vermont and from 2000 to 2009 served there as an academic dean. In this role, she led the 2002 merger of the School of Nursing and the School of Allied Health Science to establish the College of Nursing and Health Sciences.

These experiences build on Dr. Rambur's substantive leadership history in health policy and payment reform. From 1991-1995 she led North Dakota's 33-member, statewide public/private health financing and delivery reform effort that led to omnibus legislation. In 2013, Dr. Rambur was appointed to Vermont's Green Mountain Care Board by Governor Peter Shumlin and served in this role until 2017. The five member Green Mountain Care board is a quasi-judicial body. It oversees Vermont's financing, payment and delivery reform and holds broad regulatory, innovation, and evaluation authority. In May 2020, Dr.. Rambur appointed to the Medicare Payment Advisory Commission by the U.S. Comptroller General, Director of the U.S. Government Accountability Office. MedPAC is an influential, nonpartisan group of policy experts who advise the U.S. Congress on Medicare payment and policy. She was reappointed to this role in 2003. She has also served on numerous advisory and governing boards, including the boards of trustees of an academic medical center and an independent community hospital.

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