Nurse practitioners' time on nonbillable activities

Area of Science:

• Health Services Research
• Nursing Practice Economics
• Healthcare Policy

Background:

• Healthcare providers, including nurse practitioners (NPs), engage in non-reimbursable activities during patient care.
• Understanding these non-billable activities is vital for the financial sustainability of current and future NP practice models.

Purpose of the Study:

• To explore and compare seven distinct non-billable activities within NP practices across diverse settings.
• To identify factors influencing the time NPs spend on non-reimbursable tasks.

Main Methods:

• A descriptive, nonexperimental design was employed.
• A survey was administered to 509 NPs regarding their daily non-billable activities.
• Binomial regression analyses and incidence rate ratios were used to analyze relationships between variables and non-billable time.

Main Results:

• Significant variations in time spent on specific non-billable activities were observed.
• Factors influencing these variations included workplace setting, the number of support staff, and the NP's primary care provider role.
• Not all variables examined showed statistical significance.

Conclusions:

• The findings highlight the impact of practice environment and support structures on NP non-billable time.
• Addressing non-billable activities is crucial given healthcare reform, reimbursement uncertainties, and the evolving roles of NPs.
• Understanding non-billable time's effect on efficiency, costs, and value can inform future healthcare reimbursement policies and care delivery models for NPs.