Posts Tagged ‘nurse practitioners’

Infographic: What Can a Nurse Practitioner do?

August 31st, 2016 by Melanie Matthews

Nurse practitioners may help to fill staffing needs at hospitals, physician practices and other healthcare organizations, according to a new infographic by Barton Associates.

The infographic looks at how nurse practitioners can practice at the top of their license.

A profitable by-product of CMS’s aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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Nurse Practitioners Slowly Gain More Access to Patients; Could Relieve Anticipated Physician Shortage

June 5th, 2014 by Cheryl Miller

Patients are slowly gaining access to care provided by advanced practice registered nurses (APRNs) as a number of states have taken steps to loosen restrictions on highly educated nurse practitioners (NPs).

Minnesota became the 19th state, plus the District of Columbia, tooffer patients full and direct access to NP service. According to the American Association of Nurse Practitioners (AANP), it is an important step that improves access to care and more effectively uses NPs to meet the state’s growing healthcare needs. Officials state the following in a press release:

This comes at a time when the changing demographics of health care, especially primary care, necessitates that states make full use of the nurse practitioner workforce. The nursing community is committed to addressing these challenges in future sessions to ensure that patients have a choice of health provider and receive full access to the health services they need.

Maryland was one of the first states to loosen existing restrictions, according to a story from the Robert Wood Johnson Foundation (RWJF). In 2010 the state replaced its requirement for lengthy collaborative agreements between NPs and physicians with less cumbersome “attestation statements” that identify a physician who is willing to collaborate when clinically necessary but do not require physician signatures.

The law eliminated situations where patients were left without care if their physician died, retired, or left the state. NPs can now open practices and serve larger patient populations. This has helped with the primary care shortage in Maryland.

And the shortage is not limited to Maryland. As the Healthcare Intelligence Network reported in a previous news story in 2013, the RAND Corporation predicted that as more Americans seek health services once newly insured under the Affordable Care Act (ACA), physician shortages could worsen, and reach as high as 45,000 by 2025.

And the recent Veterans Affairs problem that is making headlines around the world has been attributed to a shortage of primary care physicians (PCPs), as documented here in the New York Times.

Expanding the role of nurse practitioners and physician assistants could help eliminate the anticipated shortage of PCPs over the next decade, the RAND report suggested.

Other states that have taken steps to ease NP restrictions in recent years include the following:

  • In Utah, state Medicaid officials agreed to recognize and reimburse NPs for primary care services for beneficiaries.
  • Oregon’s governor signed a law that allows NPs and clinical nurse specialists to dispense prescription drugs.
  • In Iowa, the state Supreme Court ruled that NPs can supervise fluoroscopy, a high-tech X-ray, without physician supervision.
  • In 2011, North Dakota scrapped a requirement that NPs work in collaboration with physicians.

But these changes are not without their controversy. Some feel that it goes too far, that the supervision of a physician should be maintained. According to this editorial in the Times-Herald Record, “though well intentioned, such proposals underestimate the clinical importance of physicians’ expertise and overestimate the cost-effectiveness of nurse practitioners.”

Other areas of healthcare pose the same challenge. In Minnesota, a state law allows dental therapists to work under the supervision of dentists and perform many of the tasks they do, something that has been opposed nationally and in most other states.

But the field of NPs is also changing. First created in 1965 to meet the growing demand for basic pediatric care, by 2015 all new NPs will need to be trained at the doctorate level as a Doctor of Nursing Practice, and 104 new DNP programs are in development, according to a new infographic from Maryville University Master of Science in Nursing Online.

Infographic: Family Nurse Practitioners and the Affordable Care Act

October 28th, 2013 by Jackie Lyons

The Affordable Care Act (ACA) contains many provisions that will affect healthcare providers and workers across the continuum.

The ACA will provide $1.5 billion over five years to allow nurses, social workers and other professionals conduct home visits for pregnant women and young children to improve health outcomes, according to a new infographic from Simmons School of Nursing and Health Sciences. This infographic also shows how nurse practitioners contribute to primary care and provides a look at what has happened in the years since the Affordable Care Act was conceptualized and enacted.

Insurance & the New Healthcare Law

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You may also be interested in this related resource: Hospitals and Community Benefit: New Demands, New Approaches.

11 Innovations in Healthcare Case Management

July 23rd, 2012 by Jackie Lyons

According to respondents from HIN’s third annual healthcare case management survey, successful case management efforts focus on transition coaching, discharge planning, reward programs and a patient-centered approach to case management.

Despite the challenges of staffing and operating a successful case management company brought on by healthcare reform and the changing industry, respondents contributed innovative interventions that improve health and reduce costs in the populations they serve.

Eleven case management program interventions that proved to be successful are:

1. Working with local community collaboratives for transition coaching. For example, respondents collaborate with a company that performs in-home health assessments on members identified with chronic diseases. The information is sent to them and they use it to direct care for their members.

2. Scheduling home visits by nurse practitioners for selected patients.

3. Redirecting to in-network providers and coordinating services in an efficient manner to prevent delay in discharges.

4. Holding case conference meetings with the treating physicians, case managers, medical directors and other related parties to address issues related to challenging or high-risk patients.

5. Verifying medication and home healthcare strategies to prevent readmission for chronic illness within 24 to 48 hours.

6. Partnering with social workers who will spend time dealing with complex family problems and end-of-life care.

7. Getting high-risk obstetrical clients to assume greater accountability for the outcome of their pregnancies and communicating with providers and educators. Respondents noted a significant decrease in low birth weight infants for RN case-managed programs focused on these objectives.

8. Utilizing diabetes reward programs to keep measures in line.

9. Integrating case management (medical and behavioral health) for a patient-centered approach.

10. Using neutral assessment and family trust to establish realization that case managers can identify affordable and appropriate resources.

11. Attaining the Advanced Achievement in Transplant Management Certification (through Interlink Health Services) so case managers better understand and educate patients about the benefits of using a Transplant Center of Excellence for the best possible clinical and financial outcomes when a transplant is needed. Respondents report successful clinical outcomes and savings range in the 40-50 percent range.