Advanced practice registered nurses are being propelled to the forefront of the U.S. healthcare system with a new initiative under the Patient Protection and Affordable Care Act designed to strengthen primary care in the United States.
The Centers for Medicare & Medicaid Services in March announced a call for applications for the Graduate Nurse Education Demonstration, a program in which CMS will provide hospitals working with nursing schools to train APRNs with payments of up to $200 million over four years to cover the costs of the nurses’ clinical training.
“One of the many challenges impacting the delivery of healthcare in America is the need for more healthcare providers,” AARP Senior Vice President Susan Reinhard said in a statement. “As the number of baby boomers increases daily, our nation needs providers who have the necessary skills to provide the preventive services, early treatment and chronic care management needed by many older patients.”
Many states already have a shortage of primary care physicians, and that trend will continue to increase as more people gain health insurance and have access to more medical services under the Affordable Care Act.
The U.S. healthcare system also has a nurse faculty shortage, and the Institute of Medicine has previously made recommendations regarding the need to produce more highly qualified nurses capable of providing primary care services.
Reinhard said advance practice nurses can help meet this growing need, increase access to and quality of care, help reduce waste and bring down out-of-control healthcare costs.
APRNs — whether they are nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse midwives — play an important role in primary care. This new initiative will provide funds to eligible hospitals to increase the availability of clinical training settings that will bolster the skills and supply of APRNs.
“Growing the ranks of APRNs is an important way to increase the base of primary care providers in this country,” according to CMS. “In the past, the cost of clinical training has limited the ability of hospitals and other healthcare providers to accept more APRN students into their settings for clinical training.”
Under the Graduate Nurse Education Demonstration, CMS will provide reimbursement to up to five eligible hospitals for costs related to providing clinical training to APRN students added as a result of the demonstration. Hospitals participating in the demonstration must partner with accredited schools of nursing and nonhospital community-based care settings. Under certain circumstances, hospitals participating in the demonstration may also partner with other hospitals in an effort to expand the number of APRN students trained.
Payments to participating hospitals will be linked directly to the number of additional APRNs that the hospitals and their partners are able to train as a result of their participation in the demonstration.
The demonstration requires that half of clinical training occur in nonhospital settings in the community. Most clinical training in large hospitals already includes some rotations in settings that treat minority and underserved populations, but this demonstration sets a higher requirement for APRNs training in nonhospital community-based settings. Students receiving training funded by the demonstration will be encouraged to practice in nonhospital community-based settings, including in underserved areas.
The goal of the demonstration is to increase the delivery of qualified training to APRN students. The demonstration will provide APRNs with the clinical skills and training necessary to provide primary care, preventive care, transitional care, chronic care management, and other services appropriate for Medicare beneficiaries.
The demonstration, which will be operated by the Center for Medicare and Medicaid Innovation, is expected to run for four years. The deadline for submission of all proposals is 5 p.m. EST on May 21, 2012.