O'Reilly-Jacob M, Perloff J, Berkowitz S, Bock L. Nurse practitioner-owned practices and value-based payment.
J Am Assoc Nurse Pract 2021;
34:322-327. [PMID:
34225323 DOI:
10.1097/jxx.0000000000000635]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/28/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND
The United States is steadily shifting away from volume-based payments toward value-based payment for health care. The nursing model's emphasis on high-value care, such as disease prevention and health maintenance, ideally positions nurse practitioner (NP) practice owners to contribute to the goals of value-based care. However, little is known about NP participation in value-based care.
PURPOSE
To better understand NP-owned practice participation in value-based care.
METHODOLOGY
Using convenience sampling, we developed a registry of NP owned practices, which we used to conduct a web-based survey from November 2019 to February 2020.
RESULTS
Of the 47 NP-owner respondents, 40 practice in primary or specialty care. Practices are relatively small with a mean clinical staff of 4 full-time equivalent (FTE; range: 1-17), mean total staff of 7 FTE (1-28.5), and with a mean of 325 patient visits annually. A third participate in value-based payment arrangements, whereas a half are considering and three quarters are knowledgeable about value-based payment arrangements. Over 70% of practice owners report lack of knowledge, lack of financial protections, and lack of payer partnership as barriers to participation in value-based payment models.
CONCLUSIONS
NP practice owners face many challenges to taking on risk, including insufficient patient volume.
IMPLICATIONS
Joining together may allow small NP practices to participate in and thrive under value-based payment. Reducing the barriers and regulation of all NPs will enable the health care system to capitalize on the nursing model to meet the goals of value-based care.
Collapse