By Cathryn Domrose, Nurse.com
Released last month, the Centers for Medicare & Medicaid Services‘ new guidelines for accountable care organizations were a victory for many healthcare professionals dismayed by the original version released in April. Nursing organizations were concerned the original rules, which detailed a new, collaborative healthcare model, excluded advanced practice nurses and limited roles for nursing leadership. Many organizations expressed their concerns in comments to CMS administrator Donald Berwick, MD.
It seems the public outcry was heeded, and many groups, including the American Nurses Association and the American College of Nurse Practitioners, are encouraged by the changes. Some nurse leaders and educators predict nurses will be the key to success for these new programs, which emphasize care coordination, wellness, teamwork and health education — all areas of nursing expertise.
At first “baffled by the lack of explicit recognition [of nurses],” ANA’s senior policy fellow Cynthia Haney, JD, pointed out that some parts of the new rules now incorporate entire portions from ANA comments. The association had made the case for providers other than primary care physicians to have major roles in ACOs. Nurse practitioners and clinical nurse specialists are acknowledged as “significant assets” to ACOs for their part in providing quality, cost savings and care coordination, Haney said, and are fully recognized as primary care providers. Nursing leadership, particularly in process improvement and quality assurance, is recognized in the regulation. The new rules also makes clearer the ACOs’ need to show commitment to patient-centered, high-quality care, Haney said.
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