Advanced practice registered nurses (APRNs) provide critical access to primary care across the country, especially in underserved areas. To help meet the need for more APRNs, the Centers for Medicare & Medicaid Services (CMS) developed the Graduate Nurse Education (GNE) Demonstration to expand clinical training opportunities for APRN students to provide primary care, preventive care, transitional care, chronic care management, and other services for Medicare beneficiaries. Under the demonstration CMS encouraged five hospitals to partner with schools of nursing and provided reimbursement for the reasonable cost of providing clinical training to APRN students added as a result of the demonstration.

As a subcontractor, AIR evaluated the effectiveness of the demonstration in providing clinical training in community-based settings. The evaluation found that the GNE demonstration succeeded in strengthening the ability of participating schools of nursing and hospitals to identify, recruit, and manage opportunities for APRN students to receive clinical education training in community-based settings. Successful strategies included centralization and greater coordination of student placements at clinical sites and with clinical preceptors.

Schools of nursing and the APRN students likely will continue to benefit from the partner collaboration and clinical placement processes but sustaining increased student enrollments and an expanded pool of preceptors and clinical sites may be difficult without offering compensation to hospitals for clinical training costs.