Nurse practitioner–owned practices and value-based payment. Issue 2 (2nd February 2022)

• Record Type: Journal Article
• Authors: O'Reilly-Jacob, Monica; Perloff, Jennifer; Berkowitz, Sandy; Bock, Lorraine
• Is Part Of: Journal of the American Association of Nurse Practitioners. Volume 34:Issue 2(2022)
• Page Start: 322
• Page End: 327
• Publication Date: 2022-02-02
• Subjects: Nurse practitioners -- payment -- practice ownership -- self-employment -- survey -- value-based care; Nurse practitioners -- Periodicals; Nursing -- Periodicals; 610.730692
• DOI: 10.1097/JXX.0000000000000635
• Languages: English
• ISSNs: 2327-6886

Abstract

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.