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Updated: Apr 16, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Collaboration, not competition: cost analysis of neonatal nurse practitioner plus neonatologist versus
1Pediatrix Medical Group, Renton, Washington, and Family/Child Nursing Department, University of Washington, Seattle.
Background:
Although advanced practice in neonatal nursing is accepted and supported by the American Academy of Pediatrics and National Association of Neonatal Nurse Practitioners, less than one-half of all states allow independent prescriptive authority by advanced practice nurse practitioners.
Purpose:
The purpose of this study was to compare costs of a collaborative practice model that includes neonatal nurse practitioner (NNP) plus neonatologist (Neo) versus a neonatologist only (Neo-Only) practice in Washington state. Published Internet median salary figures from 3 sources were averaged to produce mean ± SD provider salaries, and costs for each care model were calculated in this descriptive, comparative study.
Findings/Results:
Median NNP versus Neo salaries were $99,773 ± $5206 versus $228,871 ± $9654, respectively (P < .0001). The NNP + Neo (5 NNP/3 Neo full-time equivalents [FTEs]) cost $1,185,475 versus Neo-Only (8 Neo FTEs) cost $1,830,960. The NNP + Neo practice model with 8 FTEs suggests a cost savings, with assumed equivalent reimbursement, of $645,485/year.
Implications For Practice:
These results may provide the impetus for more states to adopt broader scope of practice licensure for NNPs.
Implications For Research:
These data may provide rationale for analysis of actual costs and outcomes of collaborative practice.
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