1. A New Professional Expectation Nurse Participation in Health Policy: The End Stage Renal Disease (ESRD) Program Case Study Kathryn Taylor, RN December 5, 2011 Academic Advisor: Andrea Ruff Capstone Advisor: Christine Goeschel

2. Outline • Why this topic matters • Background • Nurse Participation • Recommendations

3. Why this topic matters constructionfun.wordpress.com

4. The ESRD Case-Study • A unique policy situation • Social Security Amendments of 1972 • A unique clinical situation

5. Outpatient dialysis reimbursement changes • Mandated by the Medicare Improvements for Patients and Providers Act (MIPPA) • Implemented by the Centers for Medicare and Medicaid Services (CMS)

6. Outpatient dialysis reimbursement changes • From two separate prospective payment and fee-for-service systems • Composite rate • Separately billable medications (overused?) • To one prospective payment system • Case mix-adjusted and outlier policy • Pay-for-performance

7. Nurse Participation • Kathleen Smith

8. Nurse Participation • Kathleen Smith • Nancy Sharp medschoolwatercooler.blogspot.com

9. Nurse Participation • Kathleen Smith • Nancy Sharp • Bonnie Greenspan

10. Nurse Participation • Kathleen Smith • Nancy Sharp • Bonnie Greenspan • Glenda Payne

11. Frontline Nurses dialysisnursingjobs.wordpress.com

12. Recommendations nursingjobs.org

13. Questions?