Kathryn "Kate" S. Harrod, CNM, PhD, FACNM
Candidate for Secretary
Question: What is the role of ACNM leadership in implementing the Affordable Care Act (ACA) and Institute of Medicine (IOM) report, The Future of Nursing?
Answer: The role of ACNM leadership in implementing the Affordable Care Act (ACA) and IOM report is to serve the organization by leading change, advancing health, and promoting the profession of midwifery. Members of ACNM, led by the Board of Directors (BOD), national staff, Government Affairs Committee (GAC), and the Midwives-Political Action Committee (PAC) have worked hard for years to ensure midwives were included in health care reform. ACNM leadership has supported the organizational work of the committees, divisions, and members, ultimately prevailing with the inclusion of midwives in health care reform. However, the work is not done!
The BOD needs to lead by seizing the many opportunities that are arising and ensuring midwives are included in every step of the process. Three major aspects of the ACA bill could promote midwifery and improved health for women and their families. First, there is now equitable reimbursement at 100% for midwifery services, a major triumph for ACNM.
Second, the bill calls for the promotion of comparative effectiveness research which could assist midwifery in demonstrating how we reduce mortality and costs. However, the new Patient-Centered Outcomes Research Institute that will be doing this work needs to involve midwives in their research.
A third aspect of the ACA is mandated direct access for clients to maternity and women’s health care. It also supports state legislation that mandates midwifery care; however, many states have not yet taken this step, so continued state-level work is required. A related concern is that access in the new bill will add millions of people to the health care system. Midwives need to be at the table to remind health care administrators that midwives are part of the solution for women’s health, overall cost containment, and the provision of clinical teaching of midwives to increase the work force
All of these provisions are supported by the IOM report. Nurses are to practice to the full extent of their education and training and be full partners with physicians and other health professionals in redesigning US health care.
I personally have worked on these issues over many years, finally seeing midwives receive equitable reimbursement after being a GAC member and chair, a member of the Midwives-PAC BOD, and most recently Secretary of the ACNM BOD. I believe it will take more work and continuity on the BOD to make improvements through implementation of this legislation for women and their families and I am committed to ongoing service.