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Making Nursing Visible for Healthy Communities

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Developing a structure to capture and reimburse nursing services that facilitate health and wellness in community


Health care is often limited to those able to come to medical facilities and pay for services. Many people—especially in rural areas and those facing economic barriers—may not have access and fall through the gaps leading to health disparities. Nurses are playing a critical role in bridging gaps, building trust, and connecting people to resources. However, these nursing services in the community are often invisible and not paid for or funded through philanthropic means, thus not sustainable or scalable despite the increasing needs in many communities.

What we are doing

OHSU in partnership with Adventist Health will create and build the reimbursement infrastructure for Adventist’s Community-Based Nursing Service (CBNS). CBNS delivers nursing care outside the walls of medical clinics. Registered nurses deliver care where people live using nurses’ holistic approaches and autonomous decision-making skills. CBNS focuses on people living in the rural communities in Tillamook County and Columbia County, Oregon, including people who are insured, uninsured, and those who are disconnected from the health care system. By building the evidence and direct payment infrastructure for community nursing, services will not only expand in these communities, promoting health equity, but allow similar programs to be developed and sustained nationwide.

Seiko Izumi, PhD, RN, FPCN, WAN Associate Professor, Oregon Health & Science University School of Nursing
Our vision of care isn’t boxed in by the walls of a medical facility. Instead of replicating the current delivery model where people come to clinics to receive care, we see RNs go out to the community where people live to deliver the care they need, and their services are paid. We’re envisioning a new world—for nurses and their communities—that embodies truly person-centered, accessible care.


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