Optimal Awarded Evaluation of Graduate Nurse Education Demonstration

Date: October 15, 2012

Optimal Solutions Group, LLC (Optimal) and its partner, American Institutes for Research (AIR), have been selected by the Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) to design and implement a program evaluation of the Graduate Nurse Education Demonstration, which aims to increase the supply of Advanced Practice Registered Nurses (APRNs) in the U.S. health care delivery system by providing Medicare payments to five selected hospitals for the reasonable cost of providing clinical training to APRN students. The demonstration also involves the creation of partnerships between hospitals, schools of nursing, and community-based care settings.

APRNs play a critical role in United States (U.S.) health care delivery system, providing care in a variety of roles in both acute and ambulatory settings. The demand for APRN-provided care has increased in recent years because of the shortage of primary care physicians and the rise in the demand for primary care services. This demand is expected to continue increasing as more Americans acquire access to health care coverage due to the passage of the Affordable Care Act.

The Optimal team is conducting both a process and quasi-experimental impact evaluation within a rapid-cycle framework aimed to systematically collect and report data and ensure the timely submission of high-quality deliverables to inform CMS and other stakeholders. The evaluation will examine:

1)       the growth in the number of advance practice registered nurses with respect to a specific base year as a result of the demonstration;

2)       the growth for each of the following specialties: clinical nurse specialist, nurse practitioner, certified nurse anesthetist, certified nurse-midwife; and

3)       the costs to the Medicare program as result of the demonstration.

The Optimal team will collect and analyze primary and secondary data to examine issues that pertain to cost and participation in the demonstration, including changes made within the eligible hospital(s) and multiple partners. Primary data collected will include focus groups, site visits, and a series of demonstration sites reports. Secondary data will come from the CMS hospital billing system, eligible hospital cost reports and partners of the eligible hospitals.

Learn more about the Graduate Nurse Education Demonstration.