Blog
May 18, 2010
By Sheila P. Burke, RN, MPA, FAAN, Faculty, Harvard Kennedy School of Government; Sr. Policy Advisor, Baker Donelson
Since its creation in 1965, Medicare has provided support for nursing education. Back then, the majority of nurses were educated through hospital-based diploma programs.
Over the past 45 years, Americans’ health care needs have changed, and the nursing profession has responded to meet those needs. Americans are aging, experiencing more complex health conditions, and managing multiple chronic conditions. Simultaneously, their health care is increasingly delivered outside of hospitals, in an array of community settings—clinics, ambulatory care centers, and patients’ homes. Consequently, nursing education programs in our nation’s colleges and universities have gradually replaced hospital-based diploma programs, and the number of RNs graduating from diploma schools has declined. In 2007, only four percent of registered nurses were trained in hospital-based diploma programs.
Until recently, Medicare reimbursement for nursing education had not kept pace with our changing health care landscape, continuing to primarily invest nursing education dollars in diploma programs. But, with the passage of health care reform, also comes an important recognition that advanced practiced registered nursing (APRN) skills are needed for the Medicare population. APRNs, nurses with advanced graduate education and training, can provide primary care, chronic care management, transitional care and care coordination.
The Medicare Graduate Nurse Education Demonstration Program aims to increase the number of highly-skilled APRNs to care for Americans by providing $200 million to bolster the training of these key health care professionals.
It received little attention in mainstream health care media coverage, but what occurred was nothing short of transformative. The way Medicare pays for health care truly sets the bar for our entire health system. The Patient Protection and Affordability Care Act breaks the federal funding barrier for graduate nursing education and targets dollars toward educating nurses with the specific skills needed to meet the needs of Medicare recipients. In the end, patients and the nursing profession will be better for it.
7 comments
May 17, 2010
By Beverly Malone, PhD, RN, FAAN, CEO, National League for Nursing
Dear Jen,
You can see from my salutation that I am not a bill collector! In fact, I am writing today to echo the sentiment you received from President Obama (which I read about in the Washington Post) in response to your letter to him: Always dream big.
On behalf of the National League for Nursing and AARP’s Center to Champion Nursing in America (who kindly gives us this opportunity to post on their blog), I want you to know how thrilled we are that your dreams include becoming a nurse. You were wise to take advantage of the president’s increased funding for Pell Grants, which have facilitated the return to school for so many.
With the continuing shortage of nurses, the profession really needs more people like you. And because nursing schools are so selective these days (according to the NLN’s annual survey of nursing schools, approximately one in four qualified applications are denied admission each year, due to space limitations), you are to be congratulated on your admission to the program at your local community college. Indeed, quite an achievement.
At the NLN we speak often of and provide opportunities for professional growth and lifelong learning. The associate degree can be a path directly to graduate study. With an MSN, you would qualify to join the ranks of nurse faculty and teach other aspiring nurses.
Nursing is a calling where you truly will make a difference. Working on the frontlines in hospitals, clinics, and other health care agencies that serve an economically and culturally diverse population, today’s nurses help improve access to quality health care every day. Since you lost your own health benefits when you were facing a health care crisis, I know you understand just how important that is.
Our best wishes for your speedy recovery. May you soon resume your nursing studies and continue to pursue all your dreams for yourself and your family!
Sincerely,
Beverly Malone, PhD, RN, FAAN
CEO, National League for Nursing
New York City
Editor's Note: This blog was written in response to the letter sent to President Obama by a Michigan nursing student: Washington Post, March 31.
May 7, 2010
By Jennie Chin Hansen, RN, MS, FAAN
AARP President
Chief Executive Officer, American Geriatrics Society
Throughout my career, I’ve worn many hats… as a nurse, a health care executive, a consumer voice, among others. In each of these roles, I’ve become progressively aware of the vital role advanced practice registered nurses (APRNs) must play in meeting our nation’s future primary care needs, especially given the anticipated shortage of primary care providers. The Association of American Medical Colleges predicts a shortage of 46,000 primary care physicians by 2025.
I recently joined other nurses, physicians, physician assistants, and researchers at a meeting convened by the Josiah Macy Jr. Foundation to discuss how we can best prepare a strong primary care workforce. We recognized the need to bring hospitals, nursing schools, and community-based care settings together in partnership for the preparation of APRNs if we want to achieve cost-effective, quality care for Medicare recipients.
We produced a series of recommendations, a number of which address the need for graduate nursing education and the need to remove barriers that limit – in many states – consumer access to APRN-provided primary care.
Congress and the President have also recognized the value of APRNs in providing high-quality primary care, particularly the need to increase funding for graduate nursing education. The Patient Protection and Affordable Care Act contains the Medicare Graduate Nurse Education Demonstration Program, which aims to increase the number of highly skilled APRNs by providing $200 million to bolster their training. This program also lays the foundation to transform the way Medicare pays for nursing education by targeting dollars toward educating nurses with the skills needed to care for Medicare recipients.
As I complete my tenure as AARP President, I am pleased that AARP successfully collaborated with leading nursing organizations – in effect consumers partnering with nurses – to help ensure Americans will have access to nurses with the advanced education and skills we need to receive high quality care.
