Penn researchers push new approach to training nurses

Researchers from the University of Pennsylvania in Philadelphia are calling for a modernization of how Medicare pays for training nurses — highlighting a new model of training more advanced practice nurses to practice primary care in a cost-effective way. 

Six things to know:

1. The researchers' findings stem from a recent graduate nurse education model authorized by the ACA. In three projects, each model site combined the training capacity of communities across health systems, hospitals, private medical practices, clinics, long-term care and universities.

Offering payment to Medicare providers allowed communities to increase high quality clinical training for advanced practice nurses in the settings where they are needed most.

2. Researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research and the Hospital of the University of Pennsylvania led the largest demonstration site, which included nine universities, several health systems and over 600 community healthcare providers in the Philadelphia area.

3. The article urges Medicare to adopt and fund this nurse training model on a national level. "There are significant economies of scale in organizing education across multiple universities and practice settings with a single teaching hospital hub," said Linda Aiken, PhD, director of the Center for Health Outcomes and Policy Research.

4. The researchers argue for a change in Medicare funding from diploma-driven nursing programs that produce entry-level RNs, to permanent, national training program funding for advance practice registered nurses.

5. To emphasize this point, the researchers looked at how Medicare currently allocates funds for nurse training. They found Medicare funds for nurse training have dropped from $174 million in 1991 to $122 million in 2015 (30 percent), and that most funding still goes to hospital-operated diploma programs that are training less than 5 percent of RNs.

"That analysis showed a substantial decrease in Medicare payments for nurse training between 1991 and 2015, at a time jobs for NPs are estimated to grow by 50 percent, making NPs among the top 10 jobs in the economy in terms of percent job growth," Dr. Aiken said.

6. "The GNE demonstration shows how Medicare could achieve greater value for its investments in nurse training while contributing to the development of a workforce that can better deliver the care that Medicare beneficiaries want and need," said co-author Barbara Todd, DNP, director of the CMS GNE Demonstration Project at Penn Hospital.

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