Bill Overview
Title: I CAN Act
Description: This bill allows other health care providers besides physicians (e.g., nurses) to provide certain services under Medicare and Medicaid. Among other changes, the bill (1) allows a nurse practitioner or physician assistant to fulfill documentation requirements for Medicare coverage of special shoes for diabetic individuals; (2) expedites the ability of physician assistants, nurse practitioners, and clinical nurse specialists to supervise Medicare cardiac, intensive cardiac, and pulmonary rehabilitation programs; and (3) allows nurse practitioners to certify the need for inpatient hospital services under Medicare and Medicaid.
Sponsors: Rep. Roybal-Allard, Lucille [D-CA-40]
Target Audience
Population: Individuals who are reliant on government-provided healthcare programs like Medicare and Medicaid
Estimated Size: 116000000
- The legislation primarily impacts the healthcare industry by altering who can provide and document care for Medicare and Medicaid recipients.
- It is likely to improve efficiency and accessibility of services for individuals who rely on Medicare and Medicaid, including seniors and low-income individuals.
- The bill empowers nurse practitioners, physician assistants, and other clinical nurse specialists, expanding their roles in healthcare delivery.
- A large proportion of the population in developed countries, including the US, depends on Medicare and Medicaid services.
Reasoning
- The I CAN Act impacts a significant portion of the US population dependent on Medicare and Medicaid, estimated at over 116 million people.
- The policy aims to improve healthcare accessibility and streamline processes by expanding the roles of nurse practitioners and physician assistants, which may enhance patient well-being due to improved service access and efficiency.
- Given the budget constraints, the policy changes will need to be strategically implemented to ensure cost-effectiveness while maximizing positive impacts on healthcare delivery.
- The expansion of roles can potentially increase job satisfaction and efficiency among healthcare professionals, indirectly benefiting patients.
- The policy could lead to immediate improvements in accessibility to certain medical services, reducing wait times and expediting care, especially for programs like cardiac rehabilitation.
Simulated Interviews
Retired (Florida)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- I appreciate that nurse practitioners can now handle more tasks directly, especially for my diabetes management.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Nurse Practitioner (New York)
Age: 24 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 16/20
Statement of Opinion:
- This policy allows me to use my training more fully and make a notable difference in my patients' care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 6 |
Physician Assistant (Texas)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Now I can contribute more directly to the supervision of rehabilitation programs, which is a positive change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired (California)
Age: 75 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 20/20
Statement of Opinion:
- I value quicker access to cardiac programs; this change has been much needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Clinical Nurse Specialist (Illinois)
Age: 39 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I am excited about this policy as it allows me more autonomy in my work with patients.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Retired teacher (Ohio)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 12/20
Statement of Opinion:
- Access to specialized footwear is easier now, which is a relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Factory Worker (Virginia)
Age: 57 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- This policy gives me better access to rehabilitation programs, which could improve my recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Self-employed (Michigan)
Age: 50 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 13/20
Statement of Opinion:
- The change seems beneficial as it offers better access in my area.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Registered Nurse (Georgia)
Age: 32 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 9/20
Statement of Opinion:
- I'm looking forward to possible new responsibilities and career growth opportunities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired (Arizona)
Age: 80 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 17/20
Statement of Opinion:
- Streamlining services should make my life a little easier.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Cost Estimates
Year 1: $700000000 (Low: $500000000, High: $900000000)
Year 2: $650000000 (Low: $450000000, High: $850000000)
Year 3: $600000000 (Low: $400000000, High: $800000000)
Year 5: $500000000 (Low: $300000000, High: $700000000)
Year 10: $400000000 (Low: $200000000, High: $600000000)
Year 100: $200000000 (Low: $100000000, High: $300000000)
Key Considerations
- There is a potential shift in the roles and responsibilities within the healthcare system, which may face resistance from medical professionals and institutions.
- The policy could face initial pushback due to administrative changes in Medicare and Medicaid service delivery.
- Long-term savings depend heavily on effective implementation, training, and utilization of nurse practitioners and similar professionals.