Reimbursement Parity for Nurse Practitioners (NPs) (Essay Sample)

Reimbursement Parity for Nurse Practitioners (NPs) Name Institution Course Date Reimbursement Parity for Nurse Practitioners (NPs) In their article, ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4zmvo7TU","properties":{"formattedCitation":"(Bischof & Greenberg, 2021)","plainCitation":"(Bischof & Greenberg, 2021)","noteIndex":0},"citationItems":[{"id":476,"uris":["http://zotero.org/users/local/r6h8rKwY/items/2PG7WABA"],"itemData":{"id":476,"type":"article-journal","abstract":"Reimbursement parity of nurse practitioners (NPs) and physicians is appropriate now more than ever. Studies have demonstrated that NPs provide the same quality of care as physicians, yet they do not receive the same reimbursement. The rise in full practice authority states, as well as nurse managed clinics and retail clinics, has led to more NPs practicing independently. The COVID-19 pandemic opened a need for NPs to provide a greater amount of care in more settings, and thus led to temporary removals of practice restrictions to increase access to care. This article offers a review of the issues, such as “incident to” billing; direct and indirect reimbursement; and quality of care. We consider MedPAC and reimbursement policy, post COVID-19 policy solutions, and action steps to move forward to seek reimbursement parity. The COVID-19 pandemic serendipitously led to the removal of many restrictions on NP practice, offering an opportunity for NPs to work with MedPAC to achieve full reimbursement for care provided.","container-title":"The Online Journal of Issues in Nursing","DOI":"https://doi.org/10.3912/OJIN.Vol26No02Man03","issue":"2","title":"Post COVID-19 Reimbursement Parity for Nurse Practitioners","URL":"https://ojin.nursingworld.org/table-of-contents/volume-26-2021/number-2-may-2021/post-covid-19-reimbursement-parity-for-nurse-practitioners/","volume":"26","author":[{"family":"Bischof","given":"Alycia"},{"family":"Greenberg","given":"Sherry"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Bischof & Greenberg (2021) discuss the issue of reimbursement parity for nurse practitioners (NPs) compared to physicians. They argue that NPs and physicians provide the same quality of care, and, therefore, should receive the same reimbursement. In addition, NPs have increased work, especially during the COVID-19 pandemic. Based on the current Medicare reimbursement policy, NPs can directly bill Medicare for the services performed, but reimbursement is only provided for 85% of the physician rate ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Dlswi3Ke","properties":{"formattedCitation":"(Penn Nursing (University of Pennsylvania), 2021)","plainCitation":"(Penn Nursing (University of Pennsylvania), 2021)","noteIndex":0},"citationItems":[{"id":475,"uris":["http://zotero.org/users/local/r6h8rKwY/items/WBH87EMD"],"itemData":{"id":475,"type":"webpage","abstract":"The current Medicare reimbursement policy for nurse practitioners (NPs) allows NPs to directly bill Medicare for services that they perform, but they are ...","language":"en","title":"Advocating Reimbursement Parity for Nurse Practitioners","URL":"https://www.nursing.upenn.edu/live/news/1961-advocating-reimbursement-parity-for-nurse","author":[{"family":"Penn Nursing (University of Pennsylvania)","given":""}],"accessed":{"date-parts":[["2024",4,16]]},"issued":{"date-parts":[["2021",6,16]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Penn Nursing (University of Pennsylvania), 2021). However, there is an increasing need to equate the primary care reimbursement for NPs and physicians by raising the NP reimbursement rate to 100% of the physician rate. The authors also highlight the evolution of the practice of NPs and the rationale for equal reimbursement with physicians. According to the authors, raising the reimbursement rate for NPs to 100% would act as an incentive to motivate them to work in primary care settings with a shortage of physicians. What I have learned from this article is that there are many nurse-managed retail clinics and centers across the US that deliver high-quality and cost-effective care services, and pandemics such as COVID-19 have pushed states to remove restrictions on NP practice. This means that NPs have high access to primary care, and do the same work as physicians. For this reason, NPs should receive the same reimbursement as physicians. As an NP student close to finishing school and transitioning into practice, working under full practice authority or independent role of NP would mean that the 85% reimbursement rate is detrimental. Like physicians, NPs have outstanding student loans to pay by the time they transition into practice. In addition, they also need to cover their practice overhead costs. The “incident to” billing policy favors physicians more than NPs, especially where NPs are involved in most patient visits. When the COVID-19 pandemic occurred, many NPs practiced to the full scope of their license, and since then, many states have granted them full practice authority. The COVID-19 pandemic showed the true value of NPs when they demonstrated the ability to help with the pandemic. When many states removed practice restrictions and granted NPs the full practice authority, care delivery increased while maintaining quality. According to ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MkTcvbqJ","properties":{"formattedCitation":"(Bischof & Greenberg, 2021)","plainCitation":"(Bischof & Greenberg, 2021)","noteIndex":0},"citationItems":[{"id":476,"uris":["http://zotero.org/users/local/r6h8rKwY/items/2PG7WABA"],"itemData":{"id":476,"type":"article-journal","abstract":"Reimbursement parity of nurse practitioners (NPs) and physicians is appropriate now more than ever. Studies have demonstrated that NPs provide the same quality of care as physicians, yet they do not receive the same reimbursement. The rise in full practice authority states, as well as nurse managed clinics and retail clinics, has led to more NPs practicing independently. The COVID-19 pandemic opened a need for NPs to provide a greater amount of care in more settings, and thus led to temporary removals of practice restrictions to increase access to care. This article offers a review of the issues, s...