The Role of Business and Finance as a DNP-Prepared Nurse

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When working in an executive role, nurses who have earned a Doctor of Nursing Practice (DNP) degree are expected to have in-depth knowledge of the economics behind healthcare. As healthcare becomes increasingly complex, these nurse leaders should have clinical experience, business acumen and financial savvy.

The American Organization of Nurse Executives (AONE) said nurse administrators must master business skills — ranging from financial management to information technology operations — when taking the helm of healthcare organizations. As the delivery of healthcare becomes more challenging, nurse leaders will be expected to manage the accompanying business and economic challenges.

Smiling DNP with nurse and doctor meeting in the background

DNP-educated nurses who hold leadership positions must understand the intricacies of budgeting, healthcare insurance and reimbursement, grant writing and managed care, among others. With changes to the Affordable Care Act, increasing support for single-payer healthcare billing and the increased strain on the system due to the aging population, nurse executives will be facing even more challenges in the future.

To achieve their goals, nurses who are pursuing a DNP degree should have a solid educational and experiential foundation that translates classroom and clinical learning to the boardroom. At Duquesne University, the online DNP programprovides a robust curriculum to prepare advanced practice registered nurses (APRN) for leadership responsibilities.

Essential Business and Finance Skills for DNP-Educated Nurses

In the past decade, the leading healthcare agencies, including the American College of Healthcare Executives (ACHE), American College of Physician Executives (ACPE), and AONE, have identified business acumen among the core competencies for healthcare leaders. The AONE further outlined the following essential business competencies for nurse executives:

  • Financial management

Nurse administrators should be able to develop and manage annual operating budgets, apply the fundamental concepts of economics to healthcare organizations and utilize business models to reshape healthcare delivery. In addition, they are expected to interpret financial statements, manage financial resources and ensure the accuracy of billing mechanisms. They also participate in contract negotiations with physicians, service providers and others.

  • Human resources management

As leaders, DNP-educated nurses should be prepared to manage the resources that involve employees. They must foster workplace competencies and developmental goals by participating in workforce planning to enhance employee satisfaction.  Nurse leaders oversee employee management, promote healthful work environments and implement ergonomically sound workplaces. They manage emergency-preparedness plans and formulate programs to encourage work-life balance. They develop recruitment, compensation and retention strategies.

  • Strategic management

As top executives, nurses who have DNP educations and work in administrative roles must be able to formulate and implement corporate goals and objectives. Such strategic management is intended to keep the organization competitive while operating efficiently. Some of the key goals in healthcare strategic management include conducting strength, weakness, opportunity and threat (SWOT) and gap analyses for planning. Under the umbrella of strategic management, the AONE said nurse leaders should also be prepared to critically evaluate operational objectives and achievements, identify marketing opportunities and defend the business case for nursing.

  • Information technology and management

Nursing executives are also expected to have a clear understanding of the impact of information technology (IT) on healthcare. They should be able to use technology in clinical and systems leadership settings and collaborate to prioritizethe best use of IT resources. Nurse executives should participate in identifying new technology trends and development as they pertain to patient care. They must also provide leadership for the implementation of new IT.

In addition, nursing executives are expected to have effective communication and relationship-building skills, an extensive knowledge of the local and national healthcare environment, proven leadership abilities and professional accountability.

Business Trends for the Future of Nurse Leaders

Economic experts say the future of healthcare will include more fundamental changes to the business behind medicine. Among the many trends expected in the coming years are:

  • Growth of bundled healthcare payment

Healthcare providers are increasingly moving toward bundled payment programs for healthcare services, which are aimed at lowering costs for medical procedures and treatments. Bundled payments reimburse medical facilities based on expected costs and are traditionally considered a cost-savings measure.

One such program began in April 2018 between the Atlanta-based insurance provider Emory Healthcare and retail giant Walmart to provide free spine and joint-replacement surgeries at designated medical centers. The medical centers will receive fixed payments for the care through the Walmart-sponsored health plan. Experts say bundled payments offer incentives for providers to manage costs and quality.

  • Continued emphasis on the patient experience

Patients have more choices than ever to receive medical treatment, so it is important that providers continue to improve the patient experience. Michael J. Dowling, president and CEO of Northwell Health in New York, told Becker’s Hospital Review that providing quality customer service is one step to increasing customer loyalty.

  • Questions over value-based care compensation

Research suggests providers are not being adequately compensated for treating patients with complex medical needs under the value-based care system. The value-based system is intended to advance the triple aim of healthcare: improving care, improving population health and reducing overall healthcare costs. The system rewards providers for quality of care rather than the amount of healthcare services they deliver.

  • Increased access to healthcare

The rise of retail medical clinics has changed the way consumers and healthcare professionals think about clinical settings. In December 2017, CVS Health and healthcare insurance provider Aetna merged with plans to offer low-cost healthcare services through CVS pharmacy locations nationwide. Through the merger, the insurance provider could start offering direct care and steering patients to its doctors and nurses at CVS locations, posing a threat to medical centers and hospitals.

Learning Business and Finance for Executive Nursing

In 2010, the Institute of Medicine’s seminal report, “The Future of Nursing: Leading Change, Advancing Health,” mandated nurses be prepared as leaders to meet the demands of the system. Part of being trained to become a leader is learning essential business and finance skills to drive changes in medical facilities and systems.

At Duquesne University, advanced practice registered nurses studying to earn a DNP degree examine the functions business, finance and healthcare economics plays in executive leadership. The DNP curriculum provides an opportunity for students to explore the business of healthcare and use the knowledge to refine healthcare systems.

About Duquesne University’s Online DNP Program

Duquesne University’s online DNP program prepares graduates to assume leadership roles in policy and decision-making to impact healthcare needs across communities. The DNP curriculum builds on existing knowledge for a comprehensive education that provides insight into the role business and finance play in health outcomes.

Students who work toward a DNP at Duquesne University’s online DNP program have an added advantage of being able to maintain their career and family responsibilities while pursuing the degree. For more information, visit DU’s online DNP program website.