Nurses Boost Hospital Revenues and Cut Costs

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Nurses Boost Hospital Revenues and Cut Costs

By Elizabeth Hanink, RN, BSN, PHN
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Hospitals and doctors have long had a mutually advantageous relationship. Hospitals need doctors to attract patients, for which the hospital then receives revenue. Doctors need hospitals both as a place to practice and to which they can send their acutely ill patients for care.

Patient Satisfaction

Where the nursing staff fit into this picture was less obvious, although people did notice that recruitment and retention of both doctors and nurses tend to be intertwined. However, it is now becoming increasingly obvious that nurses play a more significant role than ever in hospital revenues. Hospitals with competent, satisfied nurses are more likely to score highly in quality of care and patient satisfaction. The widespread use of the Internet and the availability of rating systems like Medicare’s Hospital Consumer Assess-ment of Healthcare Providers and Systems make it is easier than ever for patients to select (or decide to avoid) a facility based on previous patients’ assessments.

New Reimbursement Rules
Another factor is new reimbursement rules for hospital-acquired conditions. Medicare will no longer reimburse hospitals for the treatment of pressure ulcers, complications from falls or other conditions resulting from errors. Having a competent, qualified nursing staff is critical for preventing these costly adverse events. Furthermore, readmission penalties clearly decrease if nurses follow up with patients after discharge, even if that follow-up is something as inexpensive as a phone call.  


According to a new report from Duke University, even a few home visits from a professional nurse result in fewer emergency room visits and lower overall healthcare costs. The report examined results from a Durham, N.C., program called Durham Connects, in which local families of all backgrounds received one to three visits from nurses who linked the families to other services in the community and followed up by phone. The nurses were not the primary caseworkers or caregivers, serving instead as referrers for other types of ongoing community help.

Impressive Results
In the program’s first year, infants and families served by Durham Connects had 50 percent fewer emergency hospital trips and overnight visits. The positive results lasted for more than a year after the nurse visits ceased. While some groups benefited more than others, the overall pattern of reduced hospital visits held true for single- and two-parent families, families receiving Medicaid and ones with private insurance. “High-risk families were not the only ones who benefited,” says Ben Goodman, a Duke research scientist. “All families benefited. It was great to have this kind of finding almost a full year after the program was implemented.”

Cost-Effective Benefits
In the past, nurse visits have targeted low-income families with multiple visits across many months. The costs have usually run into the thousands of dollars. The Durham Connects program cost only about $700 per family.

“For a relatively small investment, the reward is significant,” says the study’s lead author, Kenneth A. Dodge, William McDougall Professor of Public Policy and the director of Duke’s Center for Child and Family Policy.

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