It’s true. Paul Ryan would like to eliminate Medicare, and replace it with a voucher system very similar to that of the Affordable Care Act. Speaker Ryan’s plan would give seniors vouchers that they could use to purchase private insurance. Sound familiar? In addition, the President Elect’s choice to head up the Department of Health and Human Services, Tom Price, supports Ryan’s push toward privatization. You can read more about it here:
Why is this important for nurses? First of all, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) have spent a lot of time and resources devising and implementing programs that prioritize and incentivize technology and informatics as a means of improving the quality and safety of care.
Health care is precariously poised at this time. Nurse leaders will face great challenges as programs such as Medicare and Medicaid face political surgery with potentially grave consequences. Should current efforts to dismantle the Medicare program and offer seniors ‘vouchers’ instead succeed, all of the quality of care initiatives and informatics incentives in existing programs will disappear. Nurse leaders will be challenged to get involved in order to protect fragile seniors and prevent the destruction of this invaluable resource, which has been paid for by monies contributed throughout a lifetime of work by the very seniors who are enrolled.
If things follow their present course, Medicare will continue to add new quality indicators and move reimbursement from a fee for service to a value-based purchasing model (Medicare.gov, n.d.). Nurse leaders will need to be aware that the care provided on their units drives a large part of the reimbursement, and be willing to ask for what they need to provide quality care to each patient.
In order to effectively lead and manage, nurse leaders will need to be informed and actively participate in the use of data and device integration to provide safe, high quality care. They will also have to advocate for their staff and patients by ensuring that technologies implemented are facilitating rather than hindering nursing workflows, and adding value to the nurse-patient experience (Roussel et al., 2016). Advocating for those at risk, such as patients covered by Medicare and Medicaid, is a fundamentally important challenge that nurse leaders must take up, as they are ethically bound to by the ANA’s Code of Ethics for Nurses.
Medicare.gov. (n.d.). Hospital VBP program payment adjustments. Retrieved from https://www.medicare.gov/hospitalcompare/data/payment-adjustments.html
Roussel, L., Thomas, P. L., & Harris, J. L. (Eds.). (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett.