Nurse practitioner reimbursement

BACKGROUND: The CombiConsultation is a consultation with the pharmacist for patients with a chronic condition, aligned with the periodic consultation with the practice nurse or general practitioner. Implementation requires adjustments in the working methods of these healthcare providers and therefore behavioural changes. AIM: The aim of this study was to identify the barriers and facilitators that determine the behavioural changes by pharmacists, general practitioners and practice nurses required for the implementation of the CombiConsultation...

Telehealth expanded health care delivery since the start of the COVID-19 public health emergency (PHE). In early 2020, emergency declarations and subsequent policy changes resulted in telehealth flexibilities to support health care providers limit the spread of disease and maintain access to health services. Pandemic policies affected provider licensing requirements, cross-state practice, telemedicine modality, prescribing rules, privacy and security discretions, and reimbursement. On January 30, 2023, the Biden Administration announced it would end the PHE on May 11, 2023, which means some telehealth flexibilities in effect since 2020 will expire at various times through December 31, 2024, in the absence of permanent legislation...

Studies have established that nurse practitioners (NPs) deliver primary care comparable to physicians in quality and cost, but most focus on Medicare, a program that reimburses NPs less than physicians. In this retrospective cohort study, we evaluated the quality and cost implications of receiving primary care from NPs compared to physicians in 14 states that reimburse NPs at the Medicaid fee-for-service (FFS) physician rate (i.e., pay parity). We linked national provider and practice data with Medicaid data for adults with diabetes and children with asthma (2012-2013)...

INTRODUCTION: To explore changes in performance, weaknesses, and utilization of the long-term care (LTC) system for older people with disabilities and dementia (OPWDD) in Zhejiang Province, China, thereby providing a reference for decision-making amid a progressively aging population. METHODS: A performance evaluation model of the LTC system for OPWDD was constructed using three dimensions: input, process, and outcome. Performance indicators and trends were calculated based on data collected from statistical yearbooks, documents, and work reports of the Bureau of Statistics and other government departments in Zhejiang Province, China, published in 2015-2021...

BACKGROUND: Nursing home entry often marks the transition into the end-of-life. In 2018, Germany legally introduced reimbursement for advance care planning (ACP according to § 132 g SGB V) in nursing homes that applied for ACP approval to improve end-of-life care. The Gut-Leben project aims to evaluate the implementation and barriers of ACP in nursing homes in Germany, with a special focus on the federal state of Lower Saxony, and provide practical recommendations for further development of end-of-life care...

BACKGROUND: Colorectal cancer screenings detect the early, treatable, and often curable stages of the disease. Screenings are now recommended beginning at 45 years of age. Health care providers are expected to have patient's complete screenings, and reimbursement rates can be affected if results are not documented. LOCAL PROBLEM: An independent review of expected organizational core measures revealed inadequate colorectal cancer screenings completed and no formal patient outreach program for patients who had not completed ordered screenings...

AIMS: Guidelines for the management of heart failure (HF) are evolving, and increasing emphasis is placed on patient-centred care. As part of the REWOLUTION HF (REal WOrLd EdUcaTION in HF) programme, we conducted two international surveys aimed at assessing healthcare professionals (HCPs)' educational needs and patients' perspectives on the care of HF. METHODS AND RESULTS: Anonymous online questionnaires co-developed by HF experts and patients assessed HCPs' educational needs (520 respondents, mostly cardiologists, in 68 countries) and patients' perceptions on HF impact and management (98 respondents in 18 countries)...

AIMS: The aim of this study was to develop insights into how and why Dutch government policies on deployment and training of nurse practitioners and physician assistants have effect and under what circumstances. DESIGN: A realist analysis using qualitative interviews. METHODS: Data analysis of 50 semi-structured interviews conducted in 2019 with healthcare providers, sectoral and professional associations, and training coordinators. Stratified purposive and snowball sampling were used...

OBJECTIVES: Compared to urban family caregivers (FCG), rural FCG experience greater burdens accessing coordinated care for their loved ones during and after hospitalization. The impact of technology-enhanced transitional palliative care (TPC) on caregiver outcomes is currently being evaluated in a randomized control trial. This study evaluates resource use and health system costs of this FCG-focused TPC intervention and potential Medicare reimbursement mechanisms. METHODS: Rural caregivers of hospitalized patients were randomized into an 8-week intervention consisting of video visits conducted by a registered nurse certified in palliative care, supplemented with phone calls and texts (n = 215), or attentional control...

BACKGROUND: In Morocco, the treatment of type 2 diabetes (T2D) is mainly focused on medication and only 2% of patients are coached towards a healthier lifestyle. In Oujda, Eastern Morocco the prevalence of T2D is 10.2%, and the current trend is alarming, especially for women. Therefore, the aim of this study is to explore healthcare professionals (HCP) views on the perceived barriers and benefits of an integrated care approach in primary healthcare centers (PHCCs) to T2D management in Oujda...

Many interdisciplinary oral health education programs have been implemented for pediatric primary care providers (e.g., pediatric nurse practitioner [PNP]) to raise awareness and gain skills related to the prevention of early childhood caries (ECC). However, no studies have evaluated if these educational programs provided to PNPs during their training resulted in clinical practice behavior changes. A 33-item survey was designed on a web-based platform (Survey Monkey) and distributed to 71 PNP graduates. The survey included demographics, current clinical practice, clinical practice behaviors, and perceived barriers to practice...

BACKGROUND: Medicare billing codes introduced in 2015 reimburses primary care providers for non-face-to-face, chronic care management (CCM) services rendered by clinical staff. PURPOSE: The purpose of this manuscript was to describe provider trends in billed CCM services and identify factors associated with CCM utilization. METHODS: Observational study using Medicare Public Use Files, 2015 to 2018. General, family, geriatric, and internal medicine physicians, nurse practitioners (NPs), and physician assistants (PAs) with billed primary care services were included...

OBJECTIVE: Among children younger than 18 years, the prevalence of long-term chronic diseases (LTDs) is not well known in France, nor the frequency of the use of healthcare services. This nationwide observational study focused on both topics over a 1-year period following the birth or birthday of French children in 2018 and compared the LTD status and use of healthcare. MATERIALS AND METHODS: We selected children living in mainland France from the national health data system (SNDS)...

BACKGROUND For quite some time, many North Carolina practitioners and health care leaders have advocated for whole-person care. There has been significant movement toward a whole-person approach to health in the state; however, challenges remain despite continuous momentum building over the years. This article reports an exploratory survey with North Carolina primary care and behavioral health providers. METHODS Providers were recruited statewide through professional associations and networks to participate in a survey regarding their experience delivering whole-person care...

BACKGROUND: Advanced practice providers (APPs) comprise an increasing proportion of the emergency medicine (EM) workforce, particularly in rural geographies. With little known regarding potential expanding practice patterns, we sought to evaluate trends in independent emergency care services billed by APPs from 2013 to 2019. METHODS: We performed a repeated cross-sectional analysis of emergency clinicians independently reimbursed for at least 50 evaluation and management (E/M) services (99281-99285, 99291) from Medicare Part B, with high-acuity services including Codes 99285 and 99291...

Nurse practitioners (NPs) are often responsible for coding patient encounters for reimbursement. Students should learn the basics of this skill during their educational preparation. On January 1, 2021, the American Medical Association and the Centers for Medicare & Medicaid Services implemented new guidelines to the evaluation and management office appointment documentation and coding. The new medical decision-making (MDM) guidelines created a learning curve for NP students, faculty, and preceptors. An additional obstacle was encountered when on-campus preclinical intensives, which included a coding practice session, were canceled due to the COVID-19 pandemic...

PURPOSE: Medicare requires tobacco dependence counseling and shared decision-making (SDM) for lung cancer screening (LCS) reimbursement. We hypothesized that initiating SDM during inpatient tobacco treatment visits would increase LCS among patients with barriers to proactively seeking outpatient preventive care. METHODS: We collected baseline assessments and performed two pilot randomized trials at our safety-net hospital. Pilot 1 tested feasibility, acceptability, and preliminary efficacy of a nurse practitioner initiating SDM for LCS during hospitalization (Inpatient SDM)...

OBJECTIVE: Our aim was to explore whether general practitioners (GPs) communicate with cancer patients on complementary and integrative medicine (CIM) in a patient-centred and case-specific manner. METHODS: We designed two cases of standardised breast cancer patients and allocated 29 GPs to hold a consultation either with Case 1 or Case 2. Case 1 presented with fears of possible physical side effects of hormone treatment. Case 2 feared a loss in social functioning because of nausea and emesis as possible side effects of chemotherapy...

AIM: To investigate the distribution of nurse practitioners (NPs) across Japan and their perceived facilitators and barriers to NP implementation in Japan. BACKGROUND: NP certification examinations have been conducted in Japan since 2011, and by 2020, there were 487 NPs in the country. The momentum of NP implementation is slower in Japan compared with other countries. METHODS: A cross-sectional descriptive study, following the STROBE guidelines, was conducted...

The 6-Minute Walk Test (6MWT) is a standardized tool used to measure lung impairment. It is used in outpatient primary and pulmonary practices to objectively assess functional exercise capacity and hypoxemia in patients with chronic lung disease. Screening for functional decrease in exercise tolerance and hypoxemia aids in initiating and maintaining the use of oxygen supplementation to improve functional improvement in chronic lung patients. It has new applications for recovering COVID-19 pneumonia patients to assess for clinical compromise...