Nurses Work Behind The Quality And Cost Effective Of Healthcare Services

1192 Words May 31st, 2015 5 Pages
According to Davila (n.d.), nurses work behind the scenes working to maximize the quality and cost effective of healthcare services. Their purpose is to conduct reviews and audits to ensure patients are receiving the proper care. This will help avert burden in the health care system such as redundant medical procedures or ineffective treatments that prolongs the client’s hospital stay. There are five ways that case managers can improve the hospital’s performance: improving the outcomes, reduction of readmissions, eliminate avoidable day, enhancing claims management and boosting the core competencies (Fink-Samnick, Owen, & Rasmussen, 2013). Case managers play a vital role in the health care systems which are considered as the face of client care. Hospitals administrators understands that the difference among getting more and getting less from CMS depends on how well all the staff members perform, but may not realize the most crucial staff members in enlightening quality and client involvement are the case managers.

By addressing the rise of healthcare costs is a vital component of health care reform act; this has produced a variety of new payment procedures (Miodonski, 2011). Managed-care plans are getting stricter on reimbursements while the Medicare Recovery Audit Contractor assessments are exerting more pressure on the hospitals ' financial health (Miodonski, 2011). The need for an effective case management program is important to keep the cost savings intact.…

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