Legislative: Economics of Nursing Invitational Conference Addresses Quality and Payment Issues in Nursing Care

This article reports on the 2007 Economics of Nursing Invitational Conference sponsored by the Robert Wood Johnson Foundation and the Rutgers Center for State Health Policy. The authors summarize conference presentations and discuss recommendations and plans for the future made at the conference.

Key Issues:

  • Growing evidence links the contributions of nurses to quality outcomes and cost savings. The value of nursing, however, is generally not visible in health finance. Instead of bundling nursing costs into room and board charges, providers could charge for nursing care on an individual patient basis or through standardized nursing-intensity weights (NIWs).
  • Targets of the Pay for Performance (P4P) initiative may not be appropriate for nursing because they do not capture the real quality of care. An alternative way to promote quality is through high-commitment, human resource (HCHR) systems, in which people work hard in the interests of the firm because they identify their interests with those of the firm.

Areas for future research include the benefits of adjusting hospital payments and comparative outcomes of P4P and HCHR systems. Total health care system redesign could give nurses more direct time with patients, increase caring factors, and maximize nurses' skills, knowledge and scopes of practice.