Bold Voices - July 2013 - (Page 10)

AT THE BEDSIDE Medicare Commission Explores Pay Inequality for APRNs A dvanced practice registered nurses (APRNs) and physician assistants (PAs) should receive equitable pay for providing the same services as physicians, members of the Medicare Payment Advisory Commission (MedPAC) recommended at a recent meeting. States’ scope-of-practice laws vary widely and thereby influence Medicare payments, reports “MedPAC Debates Better Pay for APRNs, PAs,” an article in MedPage Today. According to MedPAC, APRNs and PAs make up about 15 percent of providers but received just 4 percent of Medicare fee schedule spending in 2011, double that of 2006. In one example of pay inequality resulting from different state laws, Medicare pays an independent APRN 10 85 percent of what it pays a physician performing the same service in another state. If a state requires an APRN to work under a physician, Medicare pays 100 percent to the MedPAC recommendations include higher Medicare payment in rural or underserved areas. physician because of the physician fee schedule, even if the APRN provided the service. Although it took no official action at its meeting, MedPAC’s recommendations include incentivizing APRNs and PAs to work in rural or underserved areas by offering higher payments, using non-physician providers on a broader scale to reduce the physician shortage and removing barriers that restrict APRNs and PAs from using all of their practice abilities. “I would really wonder whether or not we couldn’t create the conditions of participation that say you can’t restrict the use of people,” Mary Naylor of the University of Pennsylvania School of Nursing, Philadelphia, says in the article. Though advanced practitioners have gained independent status in some states, resistance remains to taking physicians out of primary-care roles because of the difference in education and experience. Naylor rejects that notion, saying in the article, “We know from evidence that we have the same quality outcomes — 30 years of evidence — on … advanced practice nurses.” CRITICAL CARE RN’S $5,000 Sign-On Bonus plus Relocation Allowance Feel the rush working alongside highly skilled and compassionate professionals caring for a broad spectrum of critically ill patients. • State-of-the-art hospital opening early 2014 • Cardiothoracic surgery, Neurovascular intervention, Med Flight and Trauma • Tuition Investment Program • Global outreach to Africa, South America and South Dakota, USA Join our team in scenic La Crosse, Wisconsin where high quality healthcare meets a high standard of living! View Current RN Openings: (800) 362-9567, ext. 50016 EOE/AA

Table of Contents for the Digital Edition of Bold Voices - July 2013

Front/Digital Edition Viewing Guide
Another Angle
We Welcome New, Thank Off-going National Board Members
Managers Note Less Professionalism Among Nurses
Joint Commission: Alarm Fatigue Can Be Deadly
Many Nurses Subject to Workplace Violence
Sharps Injuries Continue to Pose Work Hazard
Medicare Commission Explores Pay Inequality for APRNs
NTI 2013 in Photos
Can iPads Disrupt Function of Implanted Heart Devices?
Copper Surfaces Can Cut in Half the Risk of HAI
In OurJournals
Boston Eds Ready for Emergencies, Some Airlines Unprepared
AACN Scholarships Support Your Future
Visionary Leaders Recognized at NTI
Step Forward

Bold Voices - July 2013