The Texas Gulf Coast Graduate Nurse Education Demonstration: Collaboration in Action.

Advance Practice Registered Nurses (APRNs) are increasing in number and their value is becoming more evident as Texas and the region face a severe shortage of primary care physicians. APRNs can assist in meeting the needs of a growing and complex healthcare system. Increasing the pool of APRNs will allow healthcare providers to improve access to care and deliver quality outcomes. Hospitals and other healthcare providers have been limited in the number of APRN students they could accept for clinical training due to cost. The Graduate Nurse Education (GNE) Demonstration project was mandated by Section 5509 of the 2010 Affordable Care Act. The primary goal of this demonstration is to increase the number of APRNs who will provide primary care, preventive care, transitional care, chronic care management, and other services for Medicare beneficiaries. To meet this demand, it is necessary to increase the number of qualified clinical training sites. As part of a collaborative effort, Memorial Hermann-Texas Medical Center was one of five healthcare systems that participated in the $200 million funded Demonstration, which offsets the reasonable cost of clinical training for APRNs. Memorial Hermann partnered with four schools of nursing - Prairie View A&M University, Texas Women's University, University of Texas Medical Branch, and University of Texas Health Science Center at Houston - as well as area hospitals and non-hospital community based centers to provide APRNs clinical training. This article describes the collaborative efforts of the Texas Gulf Coast GNE Demonstration as well as the implementation plan, results, and benefits of all participating partners and schools of nursing.

Implications for cardiology nurse practitioner billing: a comparison of hospital versus office practice.

PURPOSE: To discuss the implications for cardiology nurse practitioner (NP) billing and compare and contrast inpatient Medicare billing practices versus outpatient Medicare billing practices. DATA SOURCES: Selected articles, text books, and government websites. CONCLUSIONS: In today's complex and expensive healthcare system, there has been a steady decline in the reimbursement rate for professional services to hospitals and physicians. NPs can have a significant impact on reducing this decline by billing for services provided. IMPLICATIONS FOR PRACTICE: The cardiology NP can enhance institutional reimbursement quality and patient safety. The different billing methods such as independent billing, shared billing, and incident to billing by the cardiology NP can be complex.