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Related Experiment Videos

Promoting the nurse practitioner role in managed care

S S Cohen1, L Juszczak

  • 1Center for Health Policy, Yale University School of Nursing, New Haven, Connecticut 06536-0740, USA.

Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
|January 1, 1997
PubMed
Summary

Nurse practitioners can expand their roles in healthcare by understanding managed care, Medicaid waivers, and insurance policies. Knowledge of credentialing and compensation is key for strengthening primary and specialty care provider positions.

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Area of Science:

  • Healthcare Management
  • Nursing Practice
  • Health Policy

Background:

  • Managed care presents significant opportunities for nurse practitioners (NPs) to advance their professional roles.
  • Successful navigation of evolving healthcare systems is crucial for NPs to capitalize on these opportunities.
  • Familiarity with specific healthcare policies and financial structures is essential for NP integration into managed care.

Purpose of the Study:

  • To explore the opportunities and requirements for nurse practitioners within managed care systems.
  • To identify key knowledge areas, such as health insurance policies and credentialing, that facilitate NP role expansion.
  • To examine the potential for NPs to strengthen their positions as primary and specialty care providers.

Main Methods:

Related Experiment Videos

  • This study involved a review of managed care principles and their implications for advanced practice nursing.
  • Analysis focused on understanding the intersection of NP practice priorities and managed care objectives.
  • Key areas examined included Medicaid waivers, state insurance policies, and compensation models.

    • Main Results:

    • Nurse practitioners are well-positioned to leverage managed care for role enhancement.
    • Understanding Medicaid waivers and state health insurance regulations is critical for successful integration.
    • Knowledge of credentialing processes and compensation structures empowers NPs to establish provider roles.

    Conclusions:

    • Managed care offers a pathway for nurse practitioners to solidify and expand their roles in diverse healthcare settings.
    • NPs can enhance their value by mastering the complexities of managed care, including policy navigation and financial understanding.
    • The alignment between NP practice goals and managed care priorities supports their growth as primary and specialty care providers.