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Nurse practitioner-owned practices and value-based payment.

Monica O'Reilly-Jacob1, Jennifer Perloff2, Sandy Berkowitz3

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Nurse practitioner (NP) owned practices are shifting towards value-based care, but face barriers like low patient volume and lack of financial protections. Collaboration may help small NP practices succeed in these new payment models.

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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.