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Measuring Advanced Practice Provider Productivity at the National Comprehensive Cancer Network's Member Institutions
Diana Krause1, Karen Sharrah2, Anne Gross3
1National Comprehensive Cancer Network (NCCN), Plymouth Meeting, Pennsylvania.
Introduction:
The utilization of advanced practice providers (APPs) in oncology has been growing over the last decade; however, there is no standard method for assessing an APP's contributions to oncology care.
Methods:
The NCCN Best Practices Committee (BPC) created an APP Workgroup to develop recommendations to support the roles of APPs at NCCN Member Institutions. The Workgroup conducted surveys to understand how NCCN centers measure productivity. This article will review the survey results and provide recommendations for measuring APP productivity.
Results:
Although 54% of responding centers indicated they utilize relative value units (RVU) targets for independent APP visits, 88% of APPs are either unsure or do not believe RVUs are an effective measurement of overall productivity. Relative value units do not reflect non-billable hours, and APPs perform a significant number of non-billable tasks that are important to oncology practices. Sixty-six percent of APPs believe that measuring disease-based team productivity is a more reasonable assessment of APP productivity than measuring productivity at the individual level.
Conclusion:
Our recommendation for cancer centers is to focus on the value that APPs provide to overall care delivery. Advanced practice provider productivity metrics should consider not only the number of patients seen by APPs, but also the high quality and thorough care delivered that contributes to the overall care of the patient and practice. Advanced practice providers can help improve access to care, deliver improved outcomes, and increase patient and provider satisfaction. Reducing the focus on RVUs, accounting for important non-RVU-generating activities, and incorporating quality and team metrics will provide a better overall picture of APP productivity.
Insights
Advanced practice providers (APPs) in oncology are crucial, but current productivity measures like relative value units (RVUs) are insufficient. A shift towards valuing comprehensive care and team-based contributions is recommended for accurate APP assessment.
Area of Science:
- Oncology
- Healthcare Administration
- Advanced Practice Provider Roles
Background:
- The role of Advanced Practice Providers (APPs) in oncology has significantly expanded.
- There is a lack of standardized methods for evaluating APP contributions in cancer care settings.
- The NCCN Best Practices Committee (BPC) formed a dedicated APP Workgroup to address this gap.
Purpose of the Study:
- To survey NCCN Member Institutions on their current methods for measuring APP productivity.
- To analyze the effectiveness of existing metrics, such as relative value units (RVUs).
- To develop evidence-based recommendations for assessing APP productivity in oncology.
Main Methods:
- A survey was distributed to NCCN Member Institutions to gather data on APP productivity measurement.
- Survey results were analyzed to identify common practices and APP perceptions of these metrics.
- The study reviewed the limitations of RVU-based productivity assessments.
Main Results:
- While 54% of centers use RVU targets for independent APP visits, 88% of APPs find RVUs ineffective for measuring overall productivity.
- RVUs fail to account for essential non-billable tasks performed by APPs in oncology practices.
- A majority of APPs (66%) favor team-based productivity measures over individual metrics.
Conclusions:
- Oncology practices should prioritize metrics that reflect the overall value APPs bring to patient care delivery.
- Recommended productivity metrics should encompass patient volume, quality of care, and contributions to team-based care.
- A comprehensive approach, including non-RVU activities and quality indicators, offers a more accurate assessment of APP productivity and value.
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