Nurse practitioner-owned practices and value-based payment.

Area of Science:

• Health Services Research
• Healthcare Policy
• Nursing Practice

Background:

• The US healthcare system is transitioning from volume-based to value-based payment models.
• Nurse practitioner (NP) owned practices, with their focus on preventive and maintenance care, are well-positioned for value-based care.
• Current understanding of NP practice owner involvement in value-based care is limited.

Purpose of the Study:

• To investigate the extent and nature of NP-owned practice participation in value-based care.
• To identify facilitators and barriers to NP practice owner engagement in value-based payment arrangements.

Main Methods:

• A registry of NP-owned practices was created using convenience sampling.
• A web-based survey was administered to NP practice owners from November 2019 to February 2020.

Main Results:

• Of 47 NP-owner respondents, most practice in primary or specialty care and run small practices.
• One-third of NP-owned practices currently participate in value-based payment arrangements; half are considering it.
• Over 70% of NP practice owners cite lack of knowledge, financial protections, and payer partnerships as barriers.

Conclusions:

• NP practice owners encounter significant challenges, including insufficient patient volume, to assuming financial risk in value-based care.
• Collaboration among small NP practices could facilitate participation and success in value-based payment models.
• Reducing regulatory barriers for NPs is crucial for the healthcare system to leverage the nursing model for value-based care goals.