On October 7, a joint workshop on Accountable Care Organizations (ACOs) was held by the Federal Trade Commission, CMS (Centers for Medicare & Medicaid Services) and Office of Inspector General, Dept. of Health & Human Services (HHS). Section 3022 of the Affordable Care Act encourages groups of providers to create ACOs to manage and coordinate care for Medicare beneficiaries, and receive payments for cutting costs & meeting performance standards (to be set by HHS). Section 3021 authorizes HHS to test whether ACOs improve quality and reduce costs.

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As you may be aware, nursing leader and ANA member Mary Naylor, PhD, RN, FAAN, was recently appointed to be a commissioner on MedPAC, the Medicare Payment Advisory Commission. MedPAC is charged with advising Congress and CMS (the Centers for Medicare & Medicaid Services) on Medicare and Medicaid policies, including annual payment updates for the Medicare prospective payment systems – such as the Physician Fee Schedule, which covers the reimbursement of APRNs (advanced practice registered nurses).

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At the January 14-15, 2010 meeting of the Medicare Payment Advisory Commission, commonly known as MedPAC, commissioners supported a greater focus on non-physician Medicare providers, and recognized the important role of Nurse Practitioners in primary care and home health care.

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Medicare policies touch the lives of many of our patients, and reimbursement issues directly or indirectly affect financial compensation for many staff RNs and advanced practice RNs. Many APRNs are enrolled as Medicare providers, and are directly reimbursed for caring for Medicare patients. ANA GOVA staff had the opportunity recently to advocate for nurses and patients at recent meetings of MedPAC, and the RUC and CPT committees.

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