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Nurse practitioner reimbursement

Howard Orel, Molly McGroarty, Heather Marchegiani
Health care continues to evolve at a rapid rate. Over just the past decade, the industry has seen the introduction and widespread implementation of an electronic health record, increase in presence of nurse practitioners and physician assistants to help manage the shortage of physicians, and the introduction of accountable care organizations. It is with these changes that new challenges and opportunities emerge. One such challenge is the increase in the severity of medical malpractice claims throughout the nation...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
Billie Madler, Mary Helland
Maldistribution and shortages of primary care providers, changing reimbursement structures, movement from inpatient to community-based models of care, an aging population, and health care reform lead to increased numbers of patients seeking care. All of these phenomena have a part in creating a health care landscape that requires industry leaders enlist innovative strategies to meet the health care needs of their communities. Delivery of high-quality, efficient care by qualified providers is essential for the success of any health care system...
January 2017: Nursing Administration Quarterly
Natasha Gouge, Jodi Polaha, Rachel Rogers, Amy Harden
OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not...
December 2016: Southern Medical Journal
Lindsay Mullins, Lisa E Skemp, Meridean L Maas
Nurse preparation and role in community models of care for older adults is not well documented. The purpose of the current structured scoping literature review was to identify nurse-led or nurse-involved community models of care for older adults, articulate the nurse's role and preparation in the model, and identify Triple Aim policy implications. Literature from 2008 through 2014 yielded 34 models identified in 51 articles. Twenty-one of 34 models were evaluated and none clearly articulated the full impact of a nurse role...
December 1, 2016: Journal of Gerontological Nursing
Christine Petrin, Scott Kahan, M Turner, C Gallagher, W H Dietz
INTRODUCTION: Rates of obesity pharmacotherapy use, bariatric surgery and intensive behavioural counselling have been extremely low. OBJECTIVES: The primary objective of this study was to survey healthcare provider beliefs, practice and knowledge regarding obesity management. METHODS: Primary care physicians (PCPs), OB-GYN physicians and nurse practitioners (NPs) responded to a web-based survey related to drug therapy practice, bariatric surgery referral and reimbursement coding practice...
September 2016: Obesity Science & Practice
Janet G Wood
OBJECTIVE: The aim of this study was to evaluate the economic and quality outcomes associated with a collaborative advanced practice nurse and hospitalist physician model of care on the inpatient stroke unit as compared with usual hospitalist physician-led care. BACKGROUND: High functioning collaborative teams are anticipated to be essential under value-based reimbursement. METHODS: Hospitalist nurse practitioners were assigned to the stroke unit in collaboration with hospitalist physicians to implement daily hospital management for patients with stroke and transient ischemic attack...
October 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Christine Petrin, Scott Kahan, Monique Turner, Christine Gallagher, William H Dietz
INTRODUCTION: Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. METHODS: A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. RESULTS: A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity...
August 25, 2016: Obesity Research & Clinical Practice
Verena Schadewaldt, Elizabeth McInnes, Janet E Hiller, Anne Gardner
BACKGROUND: In 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models...
2016: BMC Family Practice
Lee A Jennings, Zaldy Tan, Neil S Wenger, Erin A Cook, Weijuan Han, Heather E McCreath, Katherine S Serrano, Carol P Roth, David B Reuben
Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care...
August 2016: Journal of the American Geriatrics Society
Ishani Ganguli, Eva Chittenden, Vicki Jackson, Alexa B Kimball
BACKGROUND: Early conversations between clinicians and patients about goals of care may improve patients' quality of life and prevent nonbeneficial care near the end of life, but these conversations are limited in frequency and scope. To address this issue, clinicians are increasingly asked to use standardized medical order forms, like the Medical Orders for Life-Sustaining Treatment (MOLST), to document end-of-life conversations and to help ensure that patients' wishes are realized. In kind, the Centers for Medicare and Medicaid Services recently decided to reimburse physicians as well as nurse practitioners and physician assistants for these conversations...
November 2016: Journal of Palliative Medicine
(no author information available yet)
United States Nurse practitioners and clinical nurse specialists working in rural areas of the United States will be eligible for direct Medicare reimbursement under new legislation.
March 14, 1990: Nursing Standard
Jane Currie, Mary Chiarella, Thomas Buckley
PURPOSE: Australian private practice nurse practitioner (PPNP) services have grown since legislative changes in 2010 enabled eligible nurse practitioners (NPs) to access reimbursement for care delivered through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). This article provides data from a national survey on the workforce characteristics of PPNPs in Australia. METHOD: PPNPs in Australia were invited to complete an electronic survey...
October 2016: Journal of the American Association of Nurse Practitioners
Tine Ravelingien, Franky Buyle, Sabine Deryckere, Erica Sermijn, Mieke Debrauwere, Katleen Verplancke, Steven Callens, Sabrina Commeyne, Christophe Pattyn, Dirk Vogelaers
OBJECTIVES: Some infections require prolonged parenteral antimicrobial therapy, which can be continued in an outpatient setting. The Ghent University Hospital has 15 years of experience with Outpatient Parenteral Antimicrobial Therapy (OPAT) in the home setting of the patient. METHODS: Multidisciplinary critical approach through identification of areas for improvement with the existing OPAT process within the Ghent University Hospital. Existing literature and guidelines were used as references...
May 19, 2016: Acta Clinica Belgica
Cathleen Opperman, Debra Liebig, Judith Bowling, Carol Susan Johnson, Mary Harper
In the current complex healthcare environment in which organizations are dealing with reimbursement challenges, nursing professional development practitioners must increasingly demonstrate that the time and resources dedicated to educational activities are worth the impact they have on outcomes. Measuring return on investment guides decisions on resources (people, supplies, time) used for professional development activities by showing the financial impact of such activities. The purpose of this project was to review the literature on return on investment for professional development activities to best guide decision-making for limited resources...
May 2016: Journal for Nurses in Professional Development
Hilary Barnes, Claudia B Maier, Danielle Altares Sarik, Hayley Drew Germack, Linda H Aiken, Matthew D McHugh
Increasing patient demand following health care reform has led to concerns about provider shortages, particularly in primary care and for Medicaid patients. Nurse practitioners (NPs) represent a potential solution to meeting demand. However, varying state scope of practice regulations and Medicaid reimbursement rates may limit efficient distribution of NPs. Using a national sample of 252,657 ambulatory practices, we examined the effect of state policies on NP employment in primary care and practice Medicaid acceptance...
May 13, 2016: Medical Care Research and Review: MCRR
L Abidi, A Oenema, P Nilsen, P Anderson, D van de Mheen
Despite the evidence base, alcohol screening and brief intervention (ASBI) have rarely been integrated into routine clinical practice. The aim of this study is to identify strategies that could tackle barriers to ASBI implementation in general practice by involving primary healthcare professionals and addiction prevention experts. A three-round online Delphi study was carried out in the Netherlands. The first-round questionnaire consisted of open-ended questions to generate ideas about strategies to overcome barriers...
August 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Janet Bull, Arif H Kamal, Christopher Jones, Lindsay Bonsignore, Jean Acevedo
The U.S. healthcare system is shifting from a fee-for-service (FFS) system to a valued-based reimbursement system focused on improving the quality of healthcare. The Centers for Medicare and Medicaid Services (CMS) implemented the Physician Quality Reporting System (PQRS) as an important component of this transition. All clinicians, including physicians, nurse practitioners, or physician assistants who bill to Medicare Part B FFS, should submit quality data to the PQRS in 2015 or they will receive up to a 4% negative reimbursement penalty in 2017...
August 2016: Journal of Palliative Medicine
Nagham J Ailabouni, Prasad S Nishtala, Dee Mangin, June M Tordoff
AIMS: Deprescribing is the process of reducing or discontinuing medicines that are unnecessary or deemed to be harmful. We aimed to investigate general practitioner (GP) perceived challenges to deprescribing in residential care and the possible enablers that support GPs to implement deprescribing. METHODS: A qualitative study was undertaken using semi-structured, face-to-face interviews from two cities in New Zealand and a purpose-developed pilot-tested interview schedule...
2016: PloS One
Beth D Darnall, Judith Scheman, Sara Davin, John W Burns, Jennifer L Murphy, Anna C Wilson, Robert D Kerns, Sean C Mackey
OBJECTIVE: The Institute of Medicine and the draft National Pain Strategy recently called for better training for health care clinicians. This was the first high-level needs assessment for pain psychology services and resources in the United States. DESIGN: Prospective, observational, cross-sectional. METHODS: Brief surveys were administered online to six stakeholder groups (psychologists/therapists, individuals with chronic pain, pain physicians, primary care physicians/physician assistants, nurse practitioners, and the directors of graduate and postgraduate psychology training programs)...
February 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
J Ablin, P A Ste-Marie, M Schäfer, W Häuser, M-A Fitzcharles
INTRODUCTION: The German government intends to reduce the barriers for the medical use of cannabis products. A discussion on the indications and contraindications of the medical use of cannabis and on the changes of the regulatory framework has already begun in Germany. It is useful to draw from the experiences of other countries with a more liberal medical use of cannabis. METHODS: The Israeli and Canadian experience is outlined by physicians who have been charged with expertise on the medical use of cannabis by their jurisdiction...
February 2016: Der Schmerz
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