Team-based Care – Part II
Look into many markets in the U.S. and you’re likely to find non-physician providers in greater demand and better paid than in the past few years. The 2013 HORNE Medical Office Staff Salary Survey supports this by reporting a significant upswing in the demand for non-physician providers. Survey results show a startling 68% jump in the number of non-physician providers added to hospitals and practices from 2009 to 2013. But perhaps the quick rise in demand isn’t as surprising when put into the context of the Affordable Care Act, and shrinking reimbursement.
The ACA includes a mix of new regulations, incentives and reimbursement changes that are prompting hospitals and physician practices to look for more cost-effective ways to provide high quality care for non-acute patients. Non-physician providers are emerging as one of the ways to reach this goal, with the additional benefit of helping to fill gaps in physician shortage areas.
A nurse practitioner is an example of a non-physician provider that offers patients a wide variety of primary care and specialized services. NPs are licensed independent practitioners trained to order and interpret diagnostic tests. They hold prescriptive privilege in 50 states and the District of Columbia, and in some states are allowed to practice independently without physician supervision.
The American Association of Nurse Practitioners reports that there are approximately 170,000 NPs in the U.S., serving patients in major metropolitan areas, suburban hospitals, practices and rural outposts that often suffer a shortage of physicians. NPs are trained to care for underserved populations such as the elderly. They are also trained to educate patients about disease management and lifestyle choices that promote health and wellbeing.
Their focus on overall patient health makes NPs valued members of interdisciplinary teams supported by Human Health and Services grants authorized by the ACA to promote primary care services. Although there has been some pushback from the American Medical Association on NPs leading these interdisciplinary teams in place of physicians, more than half of NPs already identify themselves as the team leader in primary patient care according to a 2013 Nurse Practitioner Survey by the Survey of Nurse Practitioners: Trend and Positions, conducted 2013 by Staff Care on behalf of the American Nurse Practitioner Foundation.
As hospitals grapple not only with shrinking reimbursement, but changes that link reimbursement to quality measures and cost-effective care, NPs are uniquely positioned to help with their specialized training in disease management and wellness.
Medical recruiters are also noting the rise in NP demand. Merritt Hawkins reports in its Review 2013 of Physician and Advanced Practitioner Recruiting Incentives that for the first time, NPs made the top 20 list of most recruited specialties, coming in 10th their first year on the list. Physician assistants, another non-physician provider, came in 12th on the list, resulting in a combined 164 percent increase in search requests for NPs and PAs in 2012-2013. This fast rise in demand is being supported by rising average salaries.
The 2013 HORNE Medical Office Staff Salary Survey shows that, after a slight downturn in 2012, NP compensation is on the rise, with an eight percent increase from 2009 to 2013, which puts average salary rates nearing $90,000. Our survey results also show that practices—including hospitals and clinics—reported an average of 8.04 non-physician providers on staff in 2013, up from 4.78 in 2009, for an increase of 68 percent since 2009.
With demand for non-physician providers increasing sharply in recent years, it's worth considering these providers as an increasing part of your recruitment strategy and provider staffing mix. NPs are highly desirable for managing non-critical primary care, educating the patient population on smart lifestyle strategies that promote wellness, and assisting hospitals and practices to stay financially healthy.
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