Granting Order-Writing Privileges to Registered Dietitian Nutritionists Can Decrease Costs in Acute Care Hospitals.

Many health care institutions are seeking to decrease the cost of providing safe, high-quality care because of changes in payment processes used by the Centers for Medicare and Medicaid Services (CMS) and other payers. Malnourished patients are at risk for poorer health outcomes, such as longer hospital length of stay, higher readmission rates, and increased mortality. 1 Lim S.L. Ong K.C. Chan Y.H. et al. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012; 31: 345-350 Abstract Full Text Full Text PDF PubMed Scopus (580) Google Scholar , 2 Felder S. Lechtenboehmer C. Bally M. et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition. 2015; 3: 1385-1393 Crossref Scopus (149) Google Scholar This increases the cost of care; however, no corresponding increase occurs in payment from insurers. Granting nutrition-related order-writing privileges (OWPs) to registered dietitian nutritionists (RDNs) can help acute-care hospitals enhance the quality of care provided to malnourished patients, improve outcomes, and decrease the costs associated with this care. Documenting potential cost savings while demonstrating improved patient outcomes can build a persuasive case to expand the scope of privileges provided to RDNs. These cost savings may be realized in direct ways, such as reduced labor and supply costs, as discussed in the first section of this article, or in indirect ways, as described in the second section of this article.