NR 510 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One

NR 510 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One

NR 510 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One

It important to first sit down and make a list of all the attributes one brings to the practice and the overall income of the practice to be able to gauge ones contract negotiations (Buppert,2015). It sounds like the owner of the practice, like any other, is financially driven which is pertinent for keeping a business up and running. As an independent contractor the provider only goes to the place of business for agreed upon services and bills appropriately for these services. As an employee one is provided with benefits, follows the hours of the business, provided the equipment they need, and get malpractice through the business not on their own (Buppert,2015). Under an ongoing contract negotiation I believe it is important to negotiate hours, wages, number of patients seen per day. Generally, an NP needs to see 20 patients a day to generate enough money to make a practice profitable, therefore I believe this a reasonable number of patients to see (Buppert,2010). It is pertinent to revisit the reimbursement regulations to ensure your knowledge is up to date. One must also confirm date of covered care according to their contract prior to seeing any patients to be ensured payment is appropriate (Hahn &Cook,2018).

Buppert, C. (2015). Nurse practitioner’s business practice & legal guide (5th ed.). Retrieved from https://bookshelf.vitalsource.com

Buppert,C. NP, JD (2010) How Many Patients Can a Nurse Practitioner See in a Day?

Hahn, J. A., & Cook, W. (2018). Lessons learned from nurse practitioner independent practice: A conversation with a nurse practitioner entrepreneur. Nursing Economics, 36(1), 18-22. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/2007005926?accountid=147674

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Carolyn Buppert suggests using the three P’s when preparing for a contract negotiation (Danielsen, Potenza, and Onieal, 2016). The three P’s stand for prepare, probe, and propose. When the negotiation discussion begins I would start of by stating the number of patients seen for the year and the billable hours that were paid. According to the AANP the US average of NPs see 3 or more patients per hour. A goal to increase revenue would be to start scheduling 3 patients per hour. According to Buppert’s payment model this will increase my revenues by more than $75,000 a year. As a contract employee I would be responsible to pay my own taxes, provide my own malpractice insurance, I would not receive medical benefits, and I would pay for my own continuing education, reducing my cost of employment to the practice. I would discuss patient satisfaction and new patient retention rates. An increase in these rates would show my value to the practice. I would also discuss patient outcomes and the increase or decrease in non-scheduled hospital admissions. A goal to increase revenue would be to decrease no-show rates. Initiating a telephone engagement protocol as stated by Clouse, Williams, and Harmon (2015) has to ability to decrease no-show rates and increase revenues. To take strain off the physician, comanagement of patients could be recommended. Comanagement means the NP and the physician work together to manage the health care needs of the same patients. Norful, de Jacq, Carlino, and Poghosyan (2018) state “the stronger comanagement is, the greater the potential for beneficial patient, clinician, and practice outcome” (p. 254). As the NP I could manage patient call backs of those with chronic illnesses that are being managed in extended care facilities.

Resources:

AANP. (2018). NP Fact Sheet. Retrieved from https://www.aanp.org/all-about-nps/np-fact-sheet.

Clouse, K., Williams, K., & Harmon, J. (2015). Improving the no-show rate of new patients in outpatient psychiatric practice: an advance practice nurse-initiated telephone engagement protocol quality improvement practice. Perspectives in Psychiatric Care, 53, 127-134.

Danielsen, , R., Potenza, A. & Onieal, M. Negotiating the professional contract. Clinician Reviews,28-33.

Decapua, M. (2016). How much revenue does a primary care nurse practitioner generate? Retrieved from https://www.bartonassociates.com/blog/how-much-revenue-does-a-primary-care-nurse-practitioner-generate/.

Norful, A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician comanagement: a theoretical model to alleviated primary care strain. Annals of Family Medicine, 16(3), 250-256.

I understand that it is a fine line in not asking for too much but as Hahn (2018) stated “We know the reward of hard

NR 510 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
NR 510 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One

work is the work itself. Insist on being paid fairly and well for doing it anyway.” People in other professions such as physicians, those in finance, lawyers, all demand respect and to be financially compensated for the services they provide why shouldn’t nursing be treated the same. I would approach the conversation of increasing productivity backed with some nursing theory of caring and giving full attention to ones patients in addition to statistical facts. There is no possible way to be fully engaged in each patient when seeing 28 to 30 patients in a single day. I would also research the money lost for a patient who returns frequently because they are not being seen for an adequate amount of quality time with their provider or feel like they didn’t get adequate care because they were rushed or if something is actually missed because they are rushed through. Many people believe NP’s share information and talk to them in the correct manner and on the right level of medical jargon (Pothula,2001)

Hahn, J. A., & Cook, W. (2018). Lessons learned from nurse practitioner independent practice: A conversation with a nurse practitioner entrepreneur. Nursing Economics, 36(1), 18-22. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/2007005926?accountid=147674

Pothula, S. M. (2001). Parent satisfaction with care provided by nurse practitioners (Order No. 1402980). Available from ProQuest Central; ProQuest Dissertations & Theses Global. (250188324). Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/250188324?accountid=147674

I enjoyed reading your postings. Highlighting the unique qualities NP’s bring to a practice is important.  There’s an urgent need for primary care services in the U.S. As the fastest growing group of professionals in the primary care workforce, NPs help to close this gap. This fills a void in the community for patients, thereby making it easier to make appointments with NP’s. Additionally, NPs focus on the whole person, providing a range of services that concentrate on patients’ mental and physical well-being, and they counsel patients about making lifestyle choices that may reduce their disease risk (Chen, 2009). This is most definitely, as you mention, a distinct quality of an NP that attracts patients to the office. A frequent distinction of an NP is their unique emphasis on the health and well being of the whole person. With a focus on health promotion, disease prevention, and health education and counseling, NPs guide patients in making smarter health and lifestyle choices, which in turn can lower patients’ out-of-pocket costs.

You also mention the fiscal factors of employment,. Because independent contractors are responsible for paying both the employer and employee portion of Social Security and Medicare (FICA), organizations are not responsible for this costly and administratively time-consuming expense. For a traditional employee, employers must pay half of the 12.4% Social Security tax and half of the 2.9% Medicare tax. In addition to initial tax savings involved, independent contractors are typically ineligible for employee benefits such as health and workers’ compensation insurance, further decreasing overall spend. According to the, Department of Labor (Links to an external site.) estimates that benefits are valued, on average, at nearly 32% of salary. These are very important points to illustrate in distinct style and fiscal benefits (Running, Hoffman & Mercer, 2008). .

Reference:

Chen LM, Farwell WR, Jha AK. (2009). Primary care visit duration and quality: does good care take longer? Arch Intern;169(20):1866-1872. http:// dx.doi.org/10.1001/archinternmed.2009.341.

Running A, Hoffman L, Mercer V. Physician perceptions of nurse practitioners: A replication study. J Am Acad Nurse Pract. 2008;20(8):429–433. doi: 10.1111/j.1745-7599.2008.00339.x