Mittelstadt P C
Division of governmental affairs, American Nurses Association.
Nurse Pract. 1993 Jan;18(1):43, 47-9. doi: 10.1097/00006205-199301000-00007.
In recent years, advanced practice nurses have achieved authority for the direct payment of their services under the four federal health programs--Medicare, Medicaid, Civilian Health and Medical Program of Uniformed Services, and the Federal Employee Health Benefit Plan. This article describes the importance of direct reimbursement and the barriers that have been overcome in achieving reimbursement. It also gives an overview of how advanced practice nurse services are covered and paid for in the federal programs. Increased authority has positioned nurses as visible members of the health care team. Direct payment for advanced practice nurses' services promotes public visibility for their role as direct providers of primary care and as managers of their patients' plan of care. Our nation is in an era of health care reform where additional primary care practitioners are needed. Recognition of advanced practice nurses allows them to be seen as a solution to our nation's pressing need for more primary care providers.
近年来，高级执业护士已在四个联邦医疗项目——医疗保险、医疗补助、军人医疗保健项目以及联邦雇员健康福利计划——下获得了其服务直接付费的授权。本文阐述了直接报销的重要性以及在实现报销过程中所克服的障碍。它还概述了联邦项目中高级执业护士服务的覆盖范围及付费方式。权力的增加使护士成为医疗团队中引人注目的成员。对高级执业护士服务的直接付费提升了他们作为初级保健直接提供者以及患者护理计划管理者角色的公众可见度。我们国家正处于医疗保健改革时代，需要更多的初级保健从业者。对高级执业护士的认可使他们被视为解决我国对更多初级保健提供者迫切需求的一个办法。
