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A New Professional Expectation

This capstone explores the critical involvement of nursing professionals in shaping health policy, focusing on the End-Stage Renal Disease (ESRD) Program. Highlighting the significance of nurse participation, it reviews historical legislative impacts, particularly the Social Security Amendments of 1972 and recent Medicare reimbursement changes. The study discusses the implications of these policies on outpatient dialysis and advocates for enhanced nurse engagement in health policy discussions to improve patient care outcomes and reimbursement strategies.

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A New Professional Expectation

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  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?

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