Health Reform & Health Policy
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RWJF Meeting & IOM Nursing Report

The Robert Wood Johnson Foundation (RWJF) is convening an invitational meeting of leaders from nursing and medicine for a discussion on Interprofessional Collaboration.   The series of discussions convened by RWJF are in response to the release of the IOM report The Future of Nursing: Leading Change, Advancing Health .  Drs. Susan Apold and Joanne Pohl are the representatives of the NP Roundtable to these important discussions.  The first meeting was held in late May 2011 and a few talking points from the meeting have emerged.

The IOM report on the Future of Nursing is a consensus report produced by the two-year initiative of the IOM and The Robert Wood Johnson Foundation to assess the needs for transforming the nursing profession.  A special committee, under the leadership of Dr. Donna Shalala, developed recommendations as an blueprint directive for the future of nursing.  Four key messages emerged from the committee:

  • Nurses should practice to the full extent of their education and training.
  • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
  • Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.
  • Effective workforce planning and policy making require better data collection and information infrastructure.

The nursing community is responding to the report by organizing forums and collaborating to discuss implementation of the report's recommendations.


Healthcare Reimbursement

The NP Roundtable has called for reform of policies on healthcare payment and reimbursement to ensure that "the true costs associated with providing quality care and should promote the effective and efficient utilization of the healthcare provider work force.”  In its "Nurse Practitioner Perspective on Health Care Payment" statement,  the NP Roundtable recommends the following:

• Support efforts that increase patient access to the full primary-care provider work force and allow for patient choice in provider selection.

• Re-engineer reimbursement systems to reflect the true costs of care to ensure that all practice settings, including primary care practices, nurse-managed health centers and emerging delivery models, can be self-sustaining.

• Promote reimbursement based on services provided.

• Track provider-specific services and outcomes; linking outcomes to specific providers will promote accountability in care.

• Recognize outcomes of care as critical indicators in effective reimbursement models.

• Include nurse practitioner-led practices and NPs as full partners in medical home, Accountable Care Organizations, insurance exchanges and other developing organizations.

• Continue to remove the outdated legislative and regulatory barriers that impede the utilization of NPs to the top of their education and abilities in addressing patient care needs.


Center to Champion Nursing

The Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation, works to increase the nation’s capacity to educate and retain nurses who are prepared and empowered to positively impact health care access, quality, and costs.   NONPF is a member of the Champion Nursing Council, which provides advice and feedback from the nursing community to the CCNA.  A significant focus of the CCNA work currently is on implementation of the IOM report on the future of nursing, and an upcoming meeting will focus on how to improve health care in rural America.  Dr. Jane Kapustin will represent NONPF in the rural health meeting.


NHSC Scholarships

 The National Health Service Corps (NHSC) provides scholarships to students willing to serve 2-4 years in an underserved community in a HPSA upon graduation and licensure.  The scholarship includes tuition and other reasonable educational costs, a monthly stipend (taxable), and assistance in locating a practice site.  Vists the NHSC Scholarship Program site for more information and to access the application.   .


Primary Care Report Available - Who Will Provide Primary Care & How Will They be Trained?

The Josiah Macy Foundation convened an invitational meeting in January 2010 to address the questions of who will provide primary care and how will they be trained.  Linda Cronenwett, PhD, RN, FAAN, former dean at the University of North Carolina Chapel School of Nursing, co-convened the conference along with Victor Dzau, MD, of Duke University.  The additional 47 meeting participants included NONPF past presidents Joanne Pohl, PhD, ANP-BC, FAAN, University of Michigan and Catherine Gilliss, DNSc, FAAN, Duke University, as well as several other nurses (Bobbie Berkowitz of the University of Washington, Jennie Chin Hansen of AARP, Susan Hassmiller of RWJ Foundation, Mary Naylor of the University of Pennsylvania, and Joan Shaver of the University of Arizona).  The Executive Summary of the conference is now available and reports the three sets of conference conclusions:  Conclusions I includes 5 recommendations pertaining to the organization and financing of health care to meet primary care needs, Conclusions II includes 4 recommendations for health professional educational models, and Conclusions III includes 3 recommendationa regarding leadership needs.  The Macy Foundation intends to release a monograph within a few months that includes background papers and more details of the conference proceedings.  "Who Will Provide Primary Care & How Will They be Trained" is available to review. 


NCQA Recognizes Nurse-Led Medical Homes

The National Commitee for Quality Assurance (NCQA) recognizes nurse-led primary care practices as patient centered medical homes in the NCQA Patient-Centered Medical Home (PCMH) 2011.  Visit the NCQA PCMH Web page for a description of the recognition program and to access a brochure and further details. 


 

Key Issues for NPs in Health Reform

When health reform legislation was in development, the following were identified as key issues for NPs by the The Nurse Practitioner Roundtable (a collaboration of the AANP, ACNP, GAPNA, NAPNAP, NPWH, and NONPF).

  • Full recognition and utilization of nurse practitioners as primary care providers in all health care systems/ models
  • Full recognition of nurse practitioner practices in coordinated care models such as Medical/Health Homes.
  • Full participation of nurse practitioners and nurse practitioner practices in Accountable Care Organizations
  • Full participation of nurse practitioners and nurse practitioner practices in chronic care and transitional care models included in the legislation
  • Maintenance of the nondiscrimination language contained in the Senate Finance Bill
  • Maintenance of the funding stream for Nurse Managed Clinics in the HELP bill.
  • Maintenance of the Graduate Nurse Education Funding Stream as proposed in the Senate Finance Bill
  • Authorization of nurse practitioners to certify patients eligible for home health care services.

 


 

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