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Midwives, Nurse Practitioners and Medicare: A Case Study Comparative Analysis of Medicare Reimbursement Efforts

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dc.contributor.advisor Chong, Elizabeth
dc.contributor.advisor Hundley, Vanora
dc.contributor.author Jessup, Debbie J.
dc.creator Jessup, Debbie J. en_US
dc.date.accessioned 2013-03-29T21:04:57Z
dc.date.available 2013-03-29T21:04:57Z
dc.date.issued 2012 en_US
dc.identifier.uri https://hdl.handle.net/1920/8098
dc.description.abstract The historic health reform law included a provision that granted 100% Medicare reimbursement to nurse-midwives, marking the culmination of a nineteen year effort by the American College of Nurse-Midwives to achieve Medicare equity for its members. The purpose of this study was to formulate an in depth understanding of the politics, personalities and processes that defined the midwife Medicare reimbursement effort, and to explore how and why the process differed from the six year nurse practitioner Medicare reimbursement effort that culminated in 85% payment. The study used a comparative case study design to explore how the legislative efforts of midwives and nurse practitioners were impacted by special interest politics, feminist political epistemologies, and the realities of the political process and climate. Relevant data were collected from professional archival documents, congressional bill summaries, and interviews with professional organization leaders and advocates; and were organized using the strategies of case description and theoretical comparison. Analysis followed in the qualitative tradition of Yin (2009) and used pattern matching and cross case synthesis analytic techniques. The study established that Feldstein's economic version of the special interest group theory was sufficient to explain the differences in process and outcome between the NP and CNM efforts, and identified strengths and weaknesses in the two groups' political competency. Bryson's feminist political theory further clarified why these processes played out differently for two seemingly similar women's professional groups, one of whose care recipients were entirely women. The findings of this study will serve as a reference and resource for increasing the political competency of nurse practitioners and midwives.
dc.format.extent 417 pages en_US
dc.language.iso en en_US
dc.rights Copyright 2012 Debbie J. Jessup en_US
dc.subject Nursing en_US
dc.subject Public policy en_US
dc.subject health policy en_US
dc.subject Medicare en_US
dc.subject nurse-midwives en_US
dc.subject nurse practitioners en_US
dc.subject nursing reimbursment en_US
dc.subject political competency en_US
dc.title Midwives, Nurse Practitioners and Medicare: A Case Study Comparative Analysis of Medicare Reimbursement Efforts en_US
dc.type Dissertation en
thesis.degree.level Doctoral en
thesis.degree.discipline Nursing en
thesis.degree.grantor George Mason University en


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