ANA Enterprise Leads National Efforts to Achieve Equitable Reimbursement of Nursing Care
MEDIA CONTACTS:
Shannon McClendon, shannon.mcclendon@ana.org
SILVER SPRING, MD - The ANA Enterprise— which includes the American Nurses Association (ANA), American Nurses Foundation (the Foundation) and the American Nurses Credentialing Center (ANCC)— has worked for decades to improve reimbursement of nursing care, foster the ongoing conversation about the nursing profession in the health care financing system, and elevate the indisputable value of nursing care. Together, we are joining key voices and driving a drumbeat for the nursing profession to achieve equitable reimbursement, which is a critical ingredient of high-quality, accessible care in all settings.
Bringing vast knowledge and expertise to every setting across a wide range of specialties, nurses provide safe, quality and culturally sensitive care to diverse patient populations and communities throughout the continuum of life. Yet, there is no denying that the systemic undervaluing of nursing care has a leading part in the workforce crisis that is now revealing troubling cracks in the nation’s health care system, especially within hospitals and critical care settings. This broken system is causing increased burnout among nurses and spurring many nurses to consider leaving their roles. In a survey of over 12,000 nurses nationwide conducted by the Foundation in November of 2022, 84 percent of nurses said they are stressed or dealing with burnout and 27% said they are considering leaving their positions. Moreover, the economic value of nursing and reimbursement for nursing care has significantly been understated and neglected. Studies have shown that despite the prominence of nursing's role in the delivery of patient care, nurses are virtually invisible when it comes to payment—nursing care is usually bundled with other facility or operational expenses despite the role of nursing in lowering the cost of care.
ANA, ANCC and the Foundation are developing forward thinking and workable strategies for all nurses, policymakers and leaders to elevate the value of the profession and reimbursement for nursing care:
Leveraging the National Provider Identifier (NPI) as the Unique Nurse Identifier.
NPIs are the gold standard for identifying and reimbursing health care professionals who provide care to patients. Use of NPIs allows providers, including Advanced Practice Registered Nurses (APRNs), to bill Medicare and Medicaid for services provided to patients. While registered nurses (RN) do not bill directly with an NPI, any nurse can obtain one. ANA is conducting a rigorous assessment of the utility of NPIs for valuing RN care. Additionally, we are considering the various operational changes required for providers and payers to be able to capture accurately the RN inputs, in aggregate or at the encounter level. Registering for an NPI is a first step toward full recognition of the value of nursing in the health care delivery system. To learn more, read ANA’s official position National Provider Identifier (NPI) as the Unique Nurse Identifier and watch this quick take video.
Equipping nurses with resources to elevate the value of nursing through direct reimbursement.
The Foundation’s Reimagining Nursing Initiative (the Initiative) is funding the expansion of nursing practice and elevating the value of nursing through direct reimbursement. The Foundation granted a record $5.5 million to support 4 bold projects developed and led by nurses that document nurses’ value to health care and create a road to reimbursement for nursing care. These projects establish models of direct reimbursement for nursing services and bring care to the places patients are – in their communities and homes. This includes clear accounting of nursing impact on outcomes, so that nurses' work and contributions are properly recognized. These grants include: a project at Emory Healthcare’s Integrated Memory Care Clinic that enables people living with dementia to receive quality, specialized nurse-led care in their homes; a collaboration with Oregon Health & Science University and Adventist Health Tillamook that develops a structure to capture and reimburse nursing services that facilitate health and wellness in the community; a new company called Navi Nurses that uses an on-demand technology to connect patients and nurses upon hospital discharge to prevent readmissions, resolve medication errors, and provide other health support to people and their caregivers; a collaboration of Boston College, Brandeis University, and the National Nurse Practitioner Entrepreneur Network to reduce barriers to value-based payment arrangements for Nurse Practitioner- and Registered Nurse owned-practices. Stay connected to this evolving work.
Framing and Articulating the Economic Value of the Nursing Profession.
Understanding nurses’ contribution to excellent patient outcomes and reducing unnecessary health care costs are essential to demonstrate value and incentivize health care organizations to align their interests with the societal goal of quality health care for all. The ANA Enterprise Research Council is broadening the understanding of the value and reimbursement of nursing care to encapsulate the full economic value of nurses’ professional practice and leadership. To that end, the ANA Enterprise Research Council is conducting research to understand new ways of quantifying nurse reimbursement and offering recommendations to fully leverage the contribution of the largest and most trusted profession for consumer benefit. ANA advocacy staff will use the data from research and feedback from members to bring practical solutions to nursing reimbursement forward to Congress, federal agencies and private health systems. To learn more about ongoing research efforts email ANAEResearchCouncil@ana.org.
To be effective at key tables on behalf of nurses , the ANA Enterprise is working to understand the economic analysis and point of view that aligns with the sustainable solutions we propose, such as modernized provider payments that reflect the actual value of nursing care. ANA, ANCC and the Foundation will share ongoing updates and announcements about these and other critical efforts underway. Please continue to stay connected via nursingworld.org and on ANA’s social media channels.
###
About the American Nurses Association
The American Nurses Association (ANA) is the premier organization representing the interests of the nation's more than 4 million registered nurses. ANA advances the profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of health care for all. For more information, visit www.nursingworld.org.
About American Nurses Foundation
American Nurses Foundation is the charitable and philanthropic arm of the American Nurses Association (ANA), with the mission to transform the nation’s health through the power of nursing. The Foundation supports research, education, and scholarships, which improve health, wellness, and patient care. For more information visit www.nursingworld.org/foundation.
About the American Nurses Credentialing Center
The mission of the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, is to promote excellence in nursing and health care globally through credentialing programs. ANCC's internationally renowned credentialing programs certify and recognize individual nurses in specialty practice areas. ANCC recognizes health care organizations that promote nursing excellence and quality patient outcomes while providing safe, positive work environments. In addition, ANCC accredits health care organizations that provide and approve continuing nursing education and accredits transition-to-practice programs that prepare nurses for new practice roles. For more information about ANCC, visit us at nursingworld.org/ANCC and follow us on Twitter. ANCC is the only nurse credentialing organization to successfully achieve ISO 9001: 2015 certification.