Hospitals in pursuit of excellence

Impact of Bundled Payments—Opportunities and Threats to Nurses

While any restructuring of the payment system will create incentives that alter providers' behaviors, bundled payments—single, all-inclusive payments for multiple services across an episode of care—are likely to have profound influences on the health care workforce. Here I contend that the impact of these new payment methodologies will present unique opportunities and threats to nurses—the single largest segment of this workforce. Though the profession's traditional roles and historical strengths are in care management and coordination, patient education and self-care management, public health and wellness, patient safety and surveillance, and transitional care (IOM, 2011), these contributions have not been typically recognized, measured, reported or rewarded. A bundled payment system could elevate the importance of these roles.