Economics and Financial Management for Nurses and Nurse Leaders 3rd Edition

Book Preface

Money is the opposite of the weather. Nobody talks about it, but everybody does
something about it.
—Rebecca Johnson

Nurses are at the forefront of health care, and experience the challenges of resource shortages every day in their clinical settings. Whether caring for the uninsured, facing budget cuts, or coping with staff shortages, nurses know the realities of problems with health care finance and economics. Unfortunately, nurses often lack the basic education and fundamental understanding needed to address these finance and economic problems.

Big changes are happening in the financing of health care systems and settings across the United States. Even if the Affordable Care Act is repealed, many of these changes will continue. Care is moving from inpatient to outpatient settings. Payment for services is moving from traditional billing from individual providers to a flat fee that is shared by all providers over a patient’s entire course of care. The American population is increasingly diverse, and an aging population not only puts more pressure on the health system, but also means that health care professionals will be leaving the workforce to retire in greater numbers than ever before. Nurses must cope with these changes and challenges by learning how to improve efficiency, reduce waste, and make their care more cost-effective.

Economics and Financial Management for Nurses and Nurse Leaders, Third Edition, is designed to help entry-level and experienced nurses understand the impact of health care economics and finance on their day-to-day clinical work. In addition, the concepts in this textbook are essential for nurse entrepreneurs, nurse managers, and other nurse leaders. Nurses will learn how national and global economics affect the health care industry, and how health insurance strategies affect consumer access and outcomes. Nurses will learn how to manage and prepare budgets and how to make a successful business case to get the resources they need to improve care in their work settings. These are all skills that nurses and nurse leaders need in this time of changes and challenges.

CONTENTS

Economics and Financial Management for Nurses and Nurse Leaders is organized into four major sections. Part I includes Chapter 1: Economics of Health Care; Chapter 2: Health Insurance and Reimbursement; and Chapter 3: Managed Care and ACOs. These chapters provide an overview of the economics and context of health care and the financing of health care in the United States. These chapters include discussions updating information about the Patient Protection and Affordable Care Act, health insurance, and new financing and delivery systems.

Part II includes Chapter 4: Measuring Nursing Care; Chapter 5: Reporting and Managing Budgets; Chapter 6: Budget Planning; and Chapter 7: Special Purpose, Capital, and Other Budgets. These chapters present indicators that are frequently reported in health care budgets, with strategies for controlling budget costs and techniques for budget preparation. The budgets most frequently reviewed by nurses working in acute care and outpatient settings are presented, particularly the operating budget.

Part III includes Chapter 8: Cost Finding, Break Even, and Charges; Chapter 9: Comparing Costs and Benefits; Chapter 10: Writing a Business Plan; and Chapter 11: Health Program Grant Writing. These chapters help nurses demonstrate support for the financial benefits of nursing interventions and develop a business case or grant proposal for improving patient care.
Part IV includes Chapter 12: Assessing Financial Health; Chapter 13: Entrepreneurship and Practice Management; Chapter 14: Ethical Issues and International Health Care Systems; and Chapter 15: Health Policy and Future Trends. Chapter 12 focuses on the financial assessment of health institutions such as hospitals, and Chapter 13 is a new addition to the textbook’s third edition, expanding on concepts of nurse entrepreneurship. The final chapters provide an overview of ethical issues and enable nurses to gain a broader understanding of other health care systems and anticipated changes in health care financing in the United States and around the world.

Economics and Financial Management for Nurses and Nurse Leaders, Third Edition, is organized so that in Part I the student first gains an overall understanding of the dynamics of health care economics and financing. In Part II, the student is prepared to plan and control costs and to recognize the importance of revenues and profitability. Skills in developing and analyzing budgets provide a foundation for leadership and for developing further proficiencies in financial management. Part III extends skills development by helping students create a financial analysis that supports a business case or grant proposal that will improve patient care. Part IV introduces more advanced topics, including understanding financial statements, entrepreneurship, international systems, and policy analysis, that reinforce lifelong and self-directed learning about economics, finance, and budgeting.

TEXTBOOK FEATURES

Important objectives and competencies from the American Organization of Nurse Executives (AONE) Nurse Executive Competencies, the American Association of Critical-Care Nurses (AACN) Financial Management in Healthcare Organizations module, and the American Association of Colleges of Nursing clinical nurse leader (CNL) certification examination are addressed throughout the textbook. In addition, end-of-chapter exercises and instructor’s materials incorporate concepts drawn from Quality and Safety Education for Nurses (QSEN) competencies.
Economics and Financial Management for Nurses and Nurse Leaders, Third Edition, uses practical case examples drawn from inpatient and outpatient health care settings throughout each chapter to illustrate the application of content. This technique assists students in developing hands-on approaches in working with financial data and financial management concerns. Nurses will learn concepts and develop fundamental skills in using tools to help them understand the economic and financial forces driving today’s health care system. Nurses will learn how to prepare budgets, business plans, and health program grant proposals with practical applications in their work settings. Many of the chapters include worksheets to help guide nurses in preparing a budget and making a business case throughout their careers.
A nursing course in economics and finance should facilitate the synthesis of information from across the curriculum and from experience working in the health professions. Students are encouraged to draw upon competencies gained from their education and experience, including:

Evidence-based practice and research principles that help in developing valid and reliable support for making a business case
Biostatistics and epidemiology concepts that enable the application and analysis of relevant data
Nursing management, leadership, and health policy theories that provide a psychosocial and political context for understanding economic and financial strategies and for evaluating and implementing business plans and grant proposals
Writing and critical thinking skills to communicate and critically appraise approaches and ideas for evaluating budgets and other financial reports, including business plans and grant proposals

Each chapter begins with a set of key learning objectives and a list of terms introduced and defined within the chapter; these terms are also included in the Glossary at the end of the book. Tables, figures, and boxes help illustrate concepts covered in the chapter. Internet resources are provided to allow further exploration of topics. Exercises at the end of each chapter help students discuss, apply, and review knowledge. The Resources section in the back of the book lists URL addresses for all websites mentioned throughout the text.

Instructors can access further aids in teaching and learning that include test questions, PowerPoint slides, and Excel files, which provide information and data from each chapter, by e-mailing [email protected]. The Excel files organize chapter terms and definitions so they can be converted to text files and uploaded to software such as the Blackboard© online course glossary, Quizlet© online flash cards, or ArmoredPenguin.com word games. Students can practice and learn from the crossword puzzles and work out end-of-chapter exercises with the Excel files by visiting www.springerpub.com/penner. There also is a free Q&A app available to all readers.

SUGGESTIONS FOR FACULTY

This textbook is designed for use either in a traditional in-class format or with online and distance teaching and learning technologies. The 15 chapters can be covered within traditional and accelerated curriculum schedules. The end-of-chapter exercises can be adapted for online discussions or in-class group works. Internet resources and supplemental materials such as sample reports and Excel files give students additional information and data for problem solving, hands-on applications, and independent learning.

Students can use the content in Chapters 10 and 11 as a basis for developing a business plan or a grant proposal as a course project and paper assignment. Such a course project emphasizes critical thinking and supports building skills in budgeting and financial analysis. The business plan or grant proposal may be assigned as individual or group work in traditional or distance learning courses. The worksheets included in Chapters 10 and 11 provide guidelines and rubrics. Students will develop and refine writing skills and gain practice in providing an evidence base as they discuss the problem and intervention in their business plan or grant proposal.