New Medicare Model Produces Expert Nurses to Address Shortage of Primary Care

A demonstration of a new model of graduate nurse education (GNE) authorized by the Affordable Care Act published in the New England Journal of Medicine supports a modernized, cost-effective version of Medicare's coverage of training in the provision of community-based primary care, reports ScienceDaily . In three projects, each GNE site, managed by one teaching hospital hub, blended the training capacity of entire communities across health systems, hospitals, private medical practices, clinics, long-term care, and universities. By offering payment to Medicare providers, communities were able to scale up high-quality training for advanced practice nurses in environments where they are most needed when they graduate. The largest demonstration site included nine universities, multiple health systems, and more than 600 community healthcare providers in the greater Philadelphia region. The researchers are urging a change in Medicare funding from diploma nursing programs that produce entry-level registered nurses to permanent, national funding of training for advance practice RNs. Analysis determined Medicare funds for nurse training have fallen 30 percent from 1991 to 2015, and that most funding still goes to hospital-operated diploma programs that currently train less than 5 percent of RNs. They also found hospitals in six states were allocated 53 percent of Medicare nurse-training funds in 2015, mainly because they have historically been home to a disproportionate number of diploma nursing schools.