Health Policy Project Based On Your Program Of Study Review ✓ Solved
Health Policy Project Based on YOUR program of study, review th
Based on your program of study, review the literature and address ONE of the following:
- FNP/AGNP: Medicare reimbursement for NPs is 85% for the same healthcare that MDs receive at 100% reimbursement. Please address questions below and state your position on this mandate.
- FNP/AGNP: What states have NP Full Practice Authority and which states have limitations or restrictions? How does this apply to your state? Please address these questions and state your position on the regulation within your state.
- Nurse Executive: What is value-based care and how will it impact decisions made at the executive level relative to nursing and AP nursing? Please address and state your position on the regulation.
- Nurse Informaticists: What law(s) was/were enacted to regulate health information? Please address and state your position on this regulation.
- Nurse Educator: What agency regulates nursing education? Explain in detail.
For the above assignment, use the following guide: Describe the current policy/status, which organization regulates and determine if it needs to change; if opposed to change, state why. Provide the process required to make the change with key players and parties of interest; identify the groups who are opposed. Explain how AP roles (which ones) could lead the effort to make or influence the change in policy or keep the policy the same and the impact in healthcare quality. My study of care is Family Nurse Practitioner. The state is Florida.
Paper For Above Instructions
The role of the Family Nurse Practitioner (FNP) in the healthcare system is crucial, particularly with the growing demand for primary care services. This paper focuses on the issue of Medicare reimbursement rates for nurse practitioners (NPs) in Florida, particularly the disparity wherein NPs receive 85% reimbursement compared to 100% for physicians. This issue raises significant questions about the equity of compensation in the healthcare system and the implications for patient care.
Current Policy and Status
Medicare reimbursement rates are determined by the Centers for Medicare and Medicaid Services (CMS), which is a federal agency under the Department of Health and Human Services. Currently, NPs are reimbursed at 85% of the physician rate for the same services provided. This policy originated from the Balanced Budget Act of 1997 and has not been significantly altered since then (Mason et al., 2016). The 85% reimbursement for NPs contrasts with the 100% reimbursement for physicians, leading to disparities in compensation despite similar training and responsibilities in a clinical setting.
Regulatory Organization
As mentioned, the regulation of reimbursement policies falls under the auspices of the CMS, while the NP practice in Florida is regulated by the Florida Board of Nursing. This Board serves to enforce the Nurse Practice Act and set policies regarding the NP scope of practice in the state (Florida Board of Nursing, 2023). Current challenges related to this reimbursement policy have prompted discussions among healthcare stakeholders regarding potential changes and advocacy for more equitable reimbursement rates.
Need for Change
There is a pressing need for change in the Medicare reimbursement policy for NPs. Advocates argue that NPs provide high-quality care that is on par with that of physicians, and therefore should be compensated equivalently (Klein et al., 2020). As healthcare shifts towards a value-based care model, it is imperative that reimbursement structures reflect the actual contributions of NPs to positive patient outcomes.
Opposition to Change
Resistance to changing the current reimbursement rate often comes from traditional physician groups who perceive NPs as a competitive threat to their practice. These groups argue that the difference in training and the role of primary care providers should be recognized in reimbursement structures. However, studies have shown that NPs can provide quality care that leads to patient satisfaction and better health outcomes, making the argument for equitable reimbursement more compelling (Weiss et al., 2017).
Key Players and Process for Change
The process for changing Medicare reimbursement rates for NPs involves several key players including professional nursing organizations, state boards, advocacy groups, and legislators. Organizations such as the American Association of Nurse Practitioners (AANP) are at the forefront of advocacy efforts to promote legislative changes that would lead to more equitable reimbursement for NPs (AANP, 2021). The process typically involves legislative proposals, lobbying efforts, and the mobilization of grassroots efforts to raise awareness about the issue.
AP Roles in Influencing Change
Advanced Practice (AP) roles, particularly FNPs, can lead efforts to influence policy changes by participating in advocacy, serving on healthcare boards, and engaging in community education initiatives. Their direct patient care experience positions them uniquely to articulate the benefits of equitable reimbursement, thereby underscoring the importance of their contributions to healthcare quality and access (Buerhaus et al., 2019).
Impact on Healthcare Quality
The impact of such policy changes on healthcare quality can be significant. Equitable reimbursement would empower NPs to practice to the full extent of their training and education, subsequently improving patient access to care and overall health outcomes. Improved reimbursement rates also have the potential to retain more providers in primary care, essential in addressing the healthcare disparities faced by many communities (Fowler et al., 2018).
Conclusion
In conclusion, the current Medicare reimbursement policy for NPs in Florida necessitates significant review and modification. The equitable treatment of NPs in reimbursement could lead to better healthcare outcomes and increased access to care for patients. As the healthcare landscape evolves, it is crucial that NPs are recognized and compensated fairly for their roles in delivering high-quality patient care.
References
- AANP. (2021). The Nurse Practitioner Role in the Future of Healthcare. American Association of Nurse Practitioners.
- Buerhaus, P. I., DesRoches, C. M., Dittus, R., & Donelan, K. (2019). Impact of Nurse Practitioners on Health Care Outcomes: A Review of Quality Evidence. Health Affairs Blog.
- Florida Board of Nursing. (2023). Nurse Practice Act and Board of Nursing FAQ. Florida Department of Health.
- Fowler, K., Timmons, A., & Wilkerson, B. (2018). The Impact of Nurse Practitioners on Primary Care Access and Quality. Journal of Community Health.
- Klein, K., Alden, R., & Buerhaus, P. (2020). Ending the Reimbursement Disparity: A Call for Action. The Nursing Outlook Journal.
- Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2016). The Future of Nursing: Leading Change, Advancing Health. National Academies Press.
- Weiss, M. E., Costa, L. L., & Costa, C. (2017). The Nurse Practitioner’s Role in Healthcare Transformation: Opportunities and Challenges. Nursing Economics.