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afraid_of_zombies ,

My wife is a nurse.

The workload increases. They can’t onboard nurses fast enough. The nurses pull in longer and longer hours. Eventually one gets burned out and takes some time off. The workload piles on the remaining nurses. Another gets burned out. The workload piles on even fewer nurses…

Solution A: bring in temp nurses. Problem, they cost more.

Solution B: go overdrive on onboarding. Problem, more time spent training less on patient care. Additional problem, there is a shortage.

Solution C: massively increase salary and find the workaholics. Problem, the insurance companies won’t change their pricing structure.

Added to all this is cost disease. You need about the same number of nurses per patient as you did decades ago.

swnt ,
@swnt@feddit.de avatar

Can you elaborate on solution C please and explain it in a bit of detail?

jeffw ,
@jeffw@lemmy.world avatar

Currently studying this. It depends on your payer mix. Medicare and Medicaid never negotiate. Insurers will negotiate reimbursement rate to docs/hospitals, depending on the situation. If one insurance company dominates the market, they won’t negotiate. Why would they? They insure 80% of a city, what can a hospital do? Refuse patients on that plan? Then they lose access to 80% of potential revenues

Edit: this is an oversimplification, but I’m not here to write an entire essay on reimbursement mechanisms. Fee for service is increasingly rare, but the same logic applies. There is another side to the argument of course. If you’re the best hospital in the area, you have leverage over the insurance company. It all depends on who you are and how popular you are, both for a hospital system and an insurer. Just like any company negotiating buying a wholesale good from another company.

min_fapper ,

Thanks for the write up. It was informative.

jeffw ,
@jeffw@lemmy.world avatar

You’re welcome! Happy to talk other questions that I can give short answers to. Insurance is a wild world

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