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Commission tackles federal payments for nurses

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A group of healthcare leaders is setting out to change federal policy to help hospitals pay for nursing staff.

At the end of the day, there’s one huge problem contributing to the nursing shortage seen at many hospitals and health systems.

“It comes down to one thing, money, and nurses never generate money for hospital systems,” Rebecca Love says. “So that is the problem. And that is something we are aiming to solve.”

Love, a well-known advocate for nursing reforms, is a co-chair of the Commission for Nurse Reimbursement. The commission formed last May and is aiming to raise awareness of the need for a fundamental shift in federal reimbursements to health systems and hospitals to support nursing. (Rebecca Love talks about the commission in this video. The story continues below.)

Medicare doesn’t offer payment to hospitals for nursing care, although Medicare offers reimbursements for surgeons and other healthcare professionals.

“Nurses are a cost to healthcare systems, and as long as they remain a cost to healthcare systems, we’re going to staff to the lowest cost denominator,” Love says.

Although hospitals are faring better at hiring and keeping nurses than a year ago, many health systems still say they are struggling with shortages of nurses, along with other key positions. Nursing advocates say health systems are seeing shortages largely due to the need to improve working conditions for nurses, and many nurses say they are burned out and don’t feel supported by their employers.

Still, the funding equation remains a major impediment, and the commission hopes to press lawmakers and policymakers to change reimbursements.

Other commission members include co-chair Sharon Pearce, former president of the American Association of Nurse Anesthesiology; Paul Coyne, senior vice president and chief nurse executive of the Hospital for Special Surgery; Bethany Hall-Long, Delaware’s lieutenant governor and a nurse; and Karen Grimley, chief nurse executive at UCLA Health.

The commission is doing fundraising and is planning to hold its first conference in May 2024. The commission is also planning to work with other nursing organizations and healthcare advocates.

So far, Love is encouraged by the response and enthusiasm for the commission. “I'm shocked to see that we have over 1,300 volunteers sign up,” Love says.

Love also says she’s particularly encouraged that hospital systems have reached out to express their support for the initiative.

Still, Love isn’t banking on overnight success. Realistically, she says it will likely take 3-5 years to win congressional support for legislation revising reimbursement policy.

“I don't think change comes easily,” Love says. “And I don't think this is a sprint. I think it's going to be a marathon. We have met with many elected officials in the Senate recently who say that the fastest change they've witnessed in their careers is a 10 year cycle.

“However, they recognize that the nursing crisis is substantially becoming more apparent to them in a way that they've never witnessed before,” she adds.

Love also recognizes that the commission will need the support of hospitals to convince policymakers of the need for reimbursements. “We don't want this to be nurses versus hospitals,” she says.

“Fundamentally, I think what our congressmen and women need to understand is that hospitals really do see this as a barrier to them being able to fund and provide nursing services,” Love says.

Even though she acknowledges it may take years to change policy on reimbursements to help pay for nurses, Love says the commission is determined to change the status quo.

“I'm in this for the long run,” Love says. “It's the fight of my career. I think it's the fight of a lot of others’ careers. And there's a lot of hubbub that always happens at the beginning. But you realize for change to happen, it's going to take a lot of negotiation and compromise behind the scenes. But we're up for it. The commission is up for the long term to make this happen.”

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