Today, the American Association of Colleges of Nursing (AACN)
is pleased to endorse the All-Payer Graduate Medical
Education Act.
AACN supports the establishment
of an all-payer trust fund to provide broad-based and stable
funding of clinical education of advanced practice nurses,
physicians, and other health care professionals. As front-line
primary care and outpatient treatment become more dominant
and hospitals focus more on acute care for the sickest patients,
the demand for advanced practice nurses (APNs) continues
to climb.
Prepared primarily at the
master's-degree level, APNs include nurse practitioners,
clinical nurse specialists, nurse anesthetists, and certified
nurse-midwives who provide a broad range of primary care
and acute care skills. This legislation represents a very
important step in supporting the clinical training of APNs
with on-going funding that is not subject to the uncertainties
of annual appropriations decisions.
Currently, Medicare -- the
largest single source of federal dollars for educating America's
largest health profession…nursing -- does not support training
for nurse practitioners and most other APNs. At the same
time, Medicare continues to subsidize hospital-based diploma
programs that have been out of the mainstream of nursing
education for decades and which produce less than 10 percent
of the nation's RNs.
In 1965, when Medicare was
created, most categories of advanced practice nursing had
not yet emerged. But, in the years since, Medicare policy
has not kept pace with the new realities of health care
consumers who require a wider choice of quality providers
across a range of inpatient and outpatient sites throughout
the community. Congressman Cardin's legislation would reform
and reduce Medicare's financial support of graduate medical
education and would make possible support for graduate-level
advanced practice nurses and other health professionals.
Creation of a trust-fund to
support training of sufficient numbers of advanced practice
nurses makes clear sense for a health system striving to
balance the competing concerns of quality, cost, and access.
The expertise of advanced nurse clinicians in delivering
high-quality care, high patient satisfaction, and cost-effectiveness
has been empirically demonstrated across many different
urban and rural settings.
In supporting graduate clinical
education for nurses, Congressman Cardin's bill would also
give hospitals, HMO's, and other facilities an incentive
-- namely, reimbursement -- to take on additional numbers
of advance practice nursing students for on-site training.
Moreover, the monies would allow hiring of additional faculty
who are critically needed.
Finally, by supporting the
production of needed clinicians, this legislation helps
to provide patients who require health services in an increasingly
outpatient world, and who must manage chronic multiple conditions,
the care most needed by them: easily accessible primary
care at a range of community-based sites.
Investment in clinical education
for advanced practice nursing is an investment in the nation's
health. We appreciate Congressman Cardin's recognition that
meeting the nation's needs for quality health care cannot
be achieved without strong support for education for the
health professions. AACN is most supportive of this legislation.
# # #
The American Association of Colleges of Nursing is the
national voice for university and four-year-college education
programs in nursing. Representing more than 585 member schools
of nursing at public and private institutions nationwide,
AACN's educational, research, governmental advocacy, data
collection, publications, and other programs work to establish
quality standards for bachelor's- and graduate-degree nursing
education, assist deans and directors to implement those
standards, influence the nursing profession to improve health
care, and promote public support of baccalaureate and graduate
nursing education, research, and practice. Web site: http://www.aacn.nche.edu
CONTACT: Robert Rosseter
(202) 463-6930, x231
rrosseter@aacn.nche.edu
