It seems the public outcry [over the draft regulations released last spring] was heeded, and many groups, including the American Nurses Association and the American College of Nurse Practitioners, are encouraged by the changes. Some nurse leaders and educators predict nurses will be the key to success for these new programs, which emphasize care coordination, wellness, teamwork and health education — all areas of nursing expertise.
What’s next for nurses and ACOs?
Although ACO guidelines do not specifically spell out nursing roles, most policy experts see nurses’ most obvious positions as care managers, educators, hospital transition coordinators, leaders of quality assurance and — for advanced practice nurses — primary care providers.
“There is lots of opportunity for nurses because of what nurses bring to the table,” said Cheryl Schraeder, RN, PhD, FAAN, director of policy and practice initiatives at the Institute for Health Care Innovation, University of Illinois at Chicago College of Nursing.
According to Patty Jones, RN, MBA, a healthcare management consultant with the Seattle office of Milliman, an actuarial consulting firm, nurses are the logical choice to help patients navigate barriers to care and to educate them about how to best care for themselves. They already serve as health coaches for patients with multiple chronic illnesses, and they perform discharge and transition planning for those who are hospitalized. Jones predicted these roles will expand in an ACO.
What kinds of roles will nurses assume?
Judith Lloyd Storfjell, RN, PhD, FAAN, said the University of Illinois at Chicago is getting requests for nurse care managers who use clinical evidence to help coordinate care for patients, including connecting them with resources, communicating with providers and giving wellness information and education on disease processes. Storfjell is professor, associate dean and executive director at the Institute for Health Care Innovation, UIC College of Nursing. A number of nursing schools are adding programs and certifications for care management.
In addition to expanding their education and training, nurses who are interested in being part of an ACO system, or of any outcomes-oriented model, need to work both within their professional organizations and among their colleagues to make their value known, say nurse leaders and policy experts.
“The central focus of an ACO will be on care coordination in a manner that includes both quality and resource use,” Jones said. “There are an awful lot of opportunities that nurses are well suited for. Now is the time to figure out where you really have the interest, passion, or excel at something in addition to clinical skills, and develop that more.”
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