Update Public Policies to Recognize the Value of Nurses


Health care is a complicated system involving many players. Most often, a discussion on health care centers around physicians, payers and patients, so it’s all too easy to overlook those on the front lines of care: dedicated nurses. Nurses play a personal, hands-on role in the lives of their patients.

Since the early days of house calls, nurses have traveled wherever people called home. As healthcare technology has evolved, nurses have led the migration of patient care out of hospitals and institutions and into homes and communities. It is through their dedication to person-centered care, commitment to support the entire family and ability to find solutions to empower patients that more and more therapies are delivered in the comfort of home.

But as far as home health and hospice care has come, there is much progress to be made – especially when it comes to ensuring our healthcare system has enough providers to adequately care for the rising number of people who will need home health and community based care in the coming years.

This is of particular concern for those who rely on Medicare-certified home health. As 10,000 baby boomers become Medicare-eligible every day, the need for home-based services grows exponentially.

The current policy landscape allows nurse practitioners (NPs), nurse anesthetists and certified nurse midwives to perform many services for Medicare beneficiairies autonomously, including admitting patients to hospitals and ordering nursing home care and prescribing medications. But when it comes to home health care, these clinicians are barred from ordering the delivery of clinically effective and low-cost care in the home. This creates a tremendous access barrier for vulnerable patients and drives up spending to the Medicare program.

In fact, the Future of Nursing report issued by the independent, objective Institute of Medicine strongly recommends that advanced practice nurses be able to practice to the full extent of their training by changing the Medicare program to allow these skilled clinicians to perform admissions assessments and certify patients for home healthcare services.

Fortunately, Senators Susan Collins (R-Maine) and Chuck Schumer (D-N.Y.) and Representative Greg Walden (R-Ore.) have introduced the bipartisan Home Health Care Planning Improvement Act in both houses of Congress. The bills would allow NPs, clinical nurse specialists, certified nurse-midwives and physician assistants to certify patient eligibility for home healthcare services under Medicare.

Home health and community care are poised to play a bigger and bigger role as Americans live longer and increasingly desire to avoid institional settings by aging in their own homes. It is imperative that we recognize the value and training nurses bring to the overall health care continuum with updated policies supportive of consumer needs and professional practice.

The changes proposed in the Home Health Care Planning Improvement Act would improve access to important home healthcare services and potentially prevent additional hospital, sub-acute care facility and nursing home admissions–all of which are costly to the consumer, the taxpayer and Medicare -while empowering nurses to practice to the full extent of their license and partner with physicians and other professionals in redesigning health care, as called for by the Institute of Medicine’s Future of Nursing report.

Tracey Moorhead is the President and CEO of the Visiting Nurse Associations of America. 

Morning Consult