Policy Evaluation Of The Affordable Care Act Graduate Nurse Education Demonstration

Abstract

The US is experiencing a shortage of primary care providers, which could be reduced by the addition of nurse practitioners. However, the ability to increase the supply of nurse practitioners is limited by a shortage of clinical preceptors. The Affordable Care Act's Graduate Nurse Education Demonstration provided federal funding to offset the clinical training costs of advanced practice nurses. We used data from the American Association of Colleges of Nursing from academic years 2005-06 through 2017-18 to determine whether the demonstration was associated with increased nurse practitioner enrollment and graduation growth. The demonstration was associated with a significant increase in nurse practitioner enrollments and graduations. A promising model of organizing and implementing funding for graduate nursing education nationally was identified. Findings suggest that modernizing Medicare payments for nursing education to support nurse practitioner clinical training costs is a promising option for increasing primary care providers.

EXHIBIT 1. Average nurse practitioner enrollments and graduations at Graduate Nurse Education (GNE) Demonstration versus non–GNE Demonstration schools of nursing, by academic year, 2006–19

SOURCE Authors’ analysis of American Association of Colleges of Nursing Annual Survey data. NOTE Years represent the end of an academic year (that is, 2006 signifies the 2005–06 academic year).