CMS initiative successfully boosts APRN enrollment

The Graduate Nurse Education Demonstration program funded by CMS just delivered a report on its success to Congress. The program offers a potential road map for narrowing the primary care gap.

In 2012, CMS dedicated up to $200 million in payments to hospitals to train advanced practice registered nurses (APRNs) with a goal of bolstering the primary care workforce. The results (PDF), recently delivered to Congress, demonstrated the program’s success, suggesting additional initiatives of its type could help primary care facilities better meet their workforce needs, according to an announcement from the University of Pennsylvania School of Nursing.

The five hospitals participating in the project included Duke University Hospital, the Hospital of the University of Pennsylvania, Memorial Hermann-Texas Medical Center, Rush University Medical Center, and HonorHealth Scottsdale Osborn Medical Center. Those hospitals encompass 19 university schools of nursing, which collectively turned out better clinical training outcomes compared to nurses trained at schools unaffiliated with the project.

Despite the popularity of graduate nursing programs, providing clinical training has presented an issue for nursing schools, said Kathleen Delaney, Ph.D., who directed the project at Rush University, in an announcement accompanying the results evaluation’s release. In general, she says, facilities provide “in-kind” training, which means schools must rely on practices with a nonmonetary incentive for training spots.

The addition of a financial incentive to the mix spurred both greater enrollment in APRN programs and better graduation rates at the demonstration schools. The project estimated the full cost of training an APRN at around $30,000, roughly a fifth as expensive as the cost reported for training a primary care physician, according to the announcement. Furthermore, the majority of the training reportedly took place in community-based primary care facilities, the sweet spot for shoring up the primary care shortage.

“The GNE demonstrated that with nominal support, you could train students in settings that hadn’t previously been able to take on that role,” said Delaney.