America’s Nurses: Cutting through the red tape to solve the home health care riddle

Every day, nearly 12 million Americans receive quality primary care and chronic care management at home.  Studies have shown that patients recuperating from illness, injury, or surgical procedures heal more quickly and successfully when recovering at home, versus in a medical facility. Additionally, these patient-centered services can improve quality of life and reduce hospital readmissions.  That’s why it’s important to ensure patients—especially Medicare beneficiaries—have timely access to home health care services.

But far too often, these vulnerable patients face unnecessary barriers to receiving home healthcare, which can result in extended hospital stays or nursing home admissions. These delays in care not only inconvenience patients and their families, but also result in increased costs to Medicare and all of us as consumers and taxpayers when patients are left in more expensive institutional settings.

{mosads}So how can we cut through the red tape to help Medicare beneficiaries get the care they need?  As the largest group of health professionals, nurses are a critical component to helping solve this health care challenge.

For nearly two decades, Medicare has recognized advanced practice nurses (APRNs)—a group that includes nurse practitioners, clinical nurse specialists, certified nurse midwives, and nurse anesthetists—as authorized Medicare providers. While APRNs are allowed to certify eligibility for nursing home care for their patients, they are prohibited from certifying eligibility for home health services for Medicare beneficiaries.  Instead, a physician must certify their assessment.

This unnecessary and burdensome regulation can lead to delays in patients receiving the right care in the right setting as APRNs are forced to locate a physician to perform a service well within their own scope of practice. Thankfully, members of Congress are working to remove this requirement through common sense, bipartisan legislation that would ensure more timely access to quality, cost effective home health services. The Home Health Care Planning Improvement Act (S. 445/H.R. 1825) would authorize nurse practitioners, clinical nurse specialists, and certified nurse midwives as eligible healthcare professionals who can certify patient eligibility for home health care services under Medicare.

APRNs are playing an increasingly vital role in our nation’s health care delivery system by practicing on their own or in collaboration with physicians. In many states, APRNs provide care in areas where access to physicians is limited; particularly in medically-underserved urban and remote rural areas. The research on this issue is clear—APRNs consistently deliver high-quality care with positive patient outcomes when they are able to work to the full extent of their education and training.

In order to meet the demands of an aging population, an integrated, national healthcare workforce that looks beyond physicians must be utilized. It is time to remove this barrier, so APRNs can provide the care they’re educated, qualified and able to do.

As the nation’s most honest and ethical profession, nurses are committed to their mission of improving the quality of healthcare for all.  And as the organization representing the interests of America’s 3.6 million registered nurses, the American Nurses Association (ANA) urges Congress to put patients first and pass the Home Health Care Planning Improvement Act.  It’s time to make common sense common again.

Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, is president of the American Nurses Association.

The views expressed by this author are their own and are not the views of The Hill.


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