1. A New Professional Expectation Nurse Participation in Health Policy: The End Stage Renal Disease (ESRD) Program Case Study Kathryn Taylor, RN December 5, 2011 Academic Advisor: Andrea Ruff Capstone Advisor: Christine Goeschel

2. Outline Why this topic matters Background Nurse Participation Recommendations

3. Why this topic matters constructionfun.wordpress.com

4. The ESRD Case-Study A unique policy situation Social Security Amendments of 1972 A unique clinical situation

5. Outpatient dialysis reimbursement changes Mandated by the Medicare Improvements for Patients and Providers Act (MIPPA) Implemented by the Centers for Medicare and Medicaid Services (CMS)

6. Outpatient dialysis reimbursement changes From two separate prospective payment and fee-for-service systems Composite rate Separately billable medications (overused?) To one prospective payment system Case mix-adjusted and outlier policy Pay-for-performance

7. Nurse Participation Kathleen Smith

8. Nurse Participation Kathleen Smith Nancy Sharp medschoolwatercooler.blogspot.com

9. Nurse Participation Kathleen Smith Nancy Sharp Bonnie Greenspan

10. Nurse Participation Kathleen Smith Nancy Sharp Bonnie Greenspan Glenda Payne

11. Frontline Nurses dialysisnursingjobs.wordpress.com

12. Recommendations nursingjobs.org

13. Questions?