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Related Experiment Videos

Managed care credentialing of advanced practice nurses

J G Rustia1, J K Bartek

  • 1College of Nursing, University of Nebraska Medical Center, Omaha, USA.

The Nurse Practitioner
|October 6, 1997
PubMed
Summary

Healthcare reform necessitates systematic credentialing and privileging for physicians in managed care. Expanded credentialing for advanced practice nurses is crucial for their role in evolving healthcare systems.

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Area of Science:

  • Healthcare Administration
  • Medical Staffing
  • Nursing Practice

Background:

  • Rapid changes in healthcare delivery necessitate reevaluation of provider relationships and quality assurance methods.
  • Emphasis on systematic credentialing, privileging, and performance evaluation for healthcare providers.
  • Managed care systems are evolving, impacting traditional healthcare delivery models.

Purpose of the Study:

  • To discuss current and evolving credentialing and privileging processes for physicians in managed care.
  • To explore the potential need for expanded credentialing for advanced practice nurses.
  • To provide insights into the evolution of credentialing, measurement sources, medicolegal issues, and suggestions for nurse credentialing.

Main Methods:

  • Review of existing credentialing and privileging processes for physicians in managed care.

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  • Analysis of the impact of managed care evolution on advanced practice nurse roles.
  • Examination of historical events, current measures, and future suggestions for nurse credentialing.

    • Main Results:

    • Physician credentialing and privileging are established but evolving within managed care.
    • Advanced practice nurses may require expanded credentialing processes to align with healthcare system changes.
    • A comprehensive credentialing system for nurses can enhance their role in reformed healthcare.

    Conclusions:

    • Systematic credentialing and privileging are essential for quality and safety in managed care.
    • The evolving healthcare landscape necessitates a reevaluation and potential expansion of advanced practice nurse credentialing.
    • Enhanced nurse credentialing will support the nursing profession's capacity to contribute significantly to healthcare reform.