Direct-Reimbursement Nursing Model

Payment defines value. The lack of reimbursement to nurses for the care they provide hides the value of the role they play in integrating quality, safety, and efficiency. The cost of nursing is accounted as a liability not an investment in patient care. In hospitals, nursing costs are bundled into the costs of patients’ rooms. When faced with difficult cost-driven decisions, nursing is often the first area to receive cuts. The direct attribution of nurses’ practice to patient outcomes is undermeasured making recognition of nurses’ contributions to patient outcomes difficult.

In communities, nursing is funded through philanthropic means or as local government services, which require advocacy and solicitation to maintain, putting the sustainability of these services in doubt and making expansion unlikely. The care provided by nurse practitioners is often unseen as many must bill under physicians’ provider identifiers rather than their own, despite the fact that they often provide the bulk of primary care.

Research proves that nurses and nurse practitioners positively affect patient outcomes through the provision of high quality, accessible, and cost-effective care. By opening payment pathways for nursing care and coordination, nurses can expand and create new places and spaces to deliver health care to patients, making health care more accessible to all.

Direct-Reimbursement Nursing Model pilots expand nursing practice and elevate the value of nursing through direct reimbursement for nursing care delivery, management, and coordination outcomes. These pilots are establishing a model of direct reimbursement for nursing services that bring care to the places patients are. This includes clear accounting of nursing impact on outcomes, so that nurses' work and contributions are properly recognized.