Clinical nurse specialists' knowledge specific to Medicare structures and processes.

Area of Science:

• Nursing Science
• Healthcare Policy

Background:

• Clinical Nurse Specialists (CNSs) play a vital role in healthcare delivery.
• Understanding complex healthcare systems like Medicare is crucial for CNSs to optimize patient care and reimbursement.
• Existing knowledge gaps among CNSs regarding Medicare may hinder their effectiveness.

Purpose of the Study:

• To assess the knowledge of clinical nurse specialists (CNSs) concerning Medicare structures and processes.
• To identify specific areas of Medicare knowledge deficits among CNSs.
• To explore CNSs' self-perceived expertise and educational needs related to Medicare.

Main Methods:

• A descriptive study utilizing a survey method with a convenience sample of CNSs.
• A 46-item multiple-choice examination was developed and administered to assess Medicare knowledge.
• Data analysis included correlating examination scores with self-reported expertise and thematic analysis of qualitative comments.

Main Results:

• The examination yielded a reliability coefficient of 0.67.
• A significant correlation (0.982) was found between examination scores and self-reported Medicare expertise.
• One-third of questions were answered incorrectly by 30% or more of respondents, indicating widespread knowledge deficits.

Conclusions:

• CNSs exhibit significant knowledge deficits in Medicare structures and processes.
• Respondents expressed a need for educational resources and networking opportunities to improve Medicare knowledge.
• There is a need for nursing education programs to integrate comprehensive Medicare and reimbursement content into their curricula.