Two Nurses Launch Commission For Nursing Reimbursement
Weird fact: did you know that nurses are the only healthcare professionals that are not allowed to bill for their services?
That’s right—as healthcare professionals providing professional healthcare services, nurses are not only not allowed to bill for their services, but their services are actually the only ones built directly into the “standard” cost of healthcare. That means that technically speaking, a nurse caring for a patient is billed in the same way, say, a box of tissues or the patient’s room is.
And while the financial model for nursing has been the same since the 1930s, a new group called the Commission for Nursing Reimbursement is dedicated to changing how the healthcare industry reimburses nursing care and, as a result, changing how the nursing profession is viewed in the process.
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The Commission for Nursing Reimbursement
The Commission for Nursing Reimbursement was officially launched in April of 2023 and as the organization explains, it was launched in response to nationwide staffing shortage concerns as a way to change the way that Medicare reimburses healthcare systems for nursing care
Led by co-chairs Rebecca Love, RN, BS, MSN, FIEL, and Sharon Pearce, DNP, CRNA, FAANA, FAAN, the Commission hopes to help address some of the financial concerns that have contributed to the nursing staffing shortage by changing the way nurses are viewed financially. Instead of seeing nursing care as an expense, it flips the model on end and turns nursing care into a billable service.
About The Founders, Rebecca Love and Sharon Pearce
Rebecca Love was the first nurse ever to be featured on TEDx.com and the first Director of Nurse Innovation & Entrepreneurship in the United States at Northeastern School of Nursing. She also founded and holds the title of President Emeritus of SONSIEL: The Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders. Similarly, Pearce has over 20 years of legislative outreach, policy strategy, and grassroots advocacy in forging relationships with congressional leaders, state, and federal agencies to make change happen.
Pearce provided insight into the Commision to Nurse.org saying, “We are on a mission to save nursing. We have never seen such a critical time in the profession with nurses leaving in droves. If we do not stop this hemorrhaging, stop overworking nurses, and value the backbone of the largest group of healthcare providers (over 4 million strong) - who is going to take care of us?”
She later went on to explain, “The current financial model is nearly 100 years old! Every other healthcare profession is a line item with a value assigned to it. Nursing has been devalued for years and seen as a cost center resulting in cuts when budgets need to be trimmed.”
The History of The Reimbursement Model of Nursing
In her Linkedin post announcing the Commission, Love explained that an advisor to the organization explained that changing the reimbursement model of nursing would effectively solve the nursing crisis.
“The reimbursement model today positions nurses as the only healthcare profession that is a sunk cost to healthcare systems,” Love said. “The way the nursing reimbursement model is constructed contrasts starkly to any other reimbursement model for healthcare professionals. All other healthcare professionals bill for their services, except for nurses.”
Healthcare as a Business
Love also made a very compelling point, noting that if you look at healthcare as a business (and in the U.S., it is treated like a profit-driven system), the business perspective is always aimed at cutting costs, not investing in them. And if nursing is a built-in “cost” of providing healthcare, it will consistently be overlooked, avoided as an investment, and even actively cut in order to build revenue
“In business, we know one does not invest in costs, you cut costs,” she said in her LinkedIn post. “And we have seen this failed economic model create an unsustainable and misaligned model where nurses and healthcare systems are in constant conflict that can be solved by allowing nurses to be a billable service.”
She added that Dr. John Welton, Professor Emeritus, University of Colorado, explained that: “The current financial model for nursing dates back to the 1930s, one that rolled nursing services into ‘room rates’ for insurance reimbursement and placed nursing services as a cost to healthcare systems.”
What Comes Next For The Commission?
Obviously, changing the entire structure and system of a 100-year-old model of nursing care and transforming it from a cost to a billable service is not something that will happen overnight. But the Commission has 15 prominent commissioners already on board, the majority of whom are nurses, working towards change.
Those fellow commissioners, Love wrote, are “ brave enough to take on a failed 100-year-old model, to correct the wrongs of the past and to change the future to create a sustainable model for nurses and with it, healthcare.”
The Commission is already getting to work too. For instance, on its website, the Commission stated that they are planning to “evaluate, review and make recommendations to the Center for Medicare and Medicaid Services on how to improve the current model of payment for nursing services within the hospitals and others.”
They also plan to work with nursing organizations and partner with healthcare groups across the nation to propose a solution to Congress that will both reduce the cost of healthcare and improve working conditions for nurses—not an easy task on either end.
But the Commission is up for the challenge. In referencing a recent CBS interview on the nursing crisis, Love noted that the organization is dedicated to ending at least one of the challenges contributing to the nursing shortage: the financial disparities.
“This is why we launched the Commission For Nurse Reimbursement,” she wrote. “So nurses will no longer ever again be short-staffed while hospital administrators’ pay continues to rise and we are told there is not enough money for nurses. #EnoughisEnough #NursesSaveLives.”
