Employing more nurse practitioners can lower health care costs

We all want to have access to health care when we are not feeling well and we want to do so without breaking our budget.  However there is growing concern about the availability of care and the increasing costs. One of the most promising responses to these concerns is the employment of more nurse practitioners by family medicine clinics and expanding their clinical roles as members of the patient care teams. There are many advantages to this approach. First it greatly improves access to care and second it can reduce costs since nurse practitioners are paid about half as much as physicians and insurance plans pay less for their patient visits. In some Family Medicine Practices nurse practitioners provide care for about one third of the patients who would otherwise be seen by a physician. Moreover some studies have found that patient satisfaction is higher in clinics that have nurse practitioners, probably because they tend to spend more time with patients and are more attentive to patients concerns.

However, while the potential of nurse practitioners to improve health care and lower cost is clearly evident our recent study found that this potential isn’t always realized.  In fact we found that in some Family Medicine Clinics with nurse practitioners patent costs are higher than in clinics without these practitioners. This raises serious questions about the ability of medical clinics to effectively utilize the full potential of nurse practitioners to improve access to affordable health care. Our study suggests that in some clinics nurse practitioners are not being included as full members of the clinical teams and that this limits their contributions to patient care while actually increasing costs. Why is this occurring? While studies have found that some physicians are reluctant to share their clinical roles with nurse practitioners there are many other factors that influence the optimal use of these practitioners including state regulations that limit their scope of work, inability to get paid for their services by some health insurance plans, and malpractice insurance concerns. How all this relates to the influence of nurse practitioner staffing ratios on the costs and quality of care is the focus of our next research projects. The employment of more nurse practitioners has great promise for improving health care but it won’t be realized unless these staffing issues are resolved.

 

Publication

The role of nurse practitioners in primary healthcare.
Kralewski J, Dowd B, Curoe A, Savage M, Tong J.
Am J Manag Care. 2015 Jun 1

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