Value based payment (VBP) can be scary. Many NP practice owners have grown up under the fee-for-service (FFS) reimbursement structure. As we are seeing and will continue to see, payment is shifting to value-based payment (VBP) models. The goal of VBP is to control costs through keeping patients healthy-- preventing disease and optimizing level of wellness. Does this sound familiar? Nursing is rooted in health promotion and disease prevention-- the hallmarks of VBP. So then why are more NP practice owners not embracing this more sustaining (clinically and financially) payment model? Let’s look at some of the reasons.
First, NP practice owners start their businesses with small patient panels, perhaps working just one day a week. This inhibits NP practice owners from reaching the critical mass necessary to participate in VBP programs.
Second, NPs tend to be bottom-up problem solvers. Being on the front line of care delivery, we focus on the immediate solution that works for the patient. That is also how we solve problems with our practices. NP practice owners need to know their practices will not be compromised, fearful of consolidation efforts that have not worked for other providers. We have slim margins and fear being corralled into the potential for financial loss . Currently, there exists no incentive for NP practice owners to create critical mass to participate in VBP programs. We don’t yet see that the potential for gain is increased, not decreased, by the patient-centeredness of our shared nursing model.
Lastly, NPs have a tendency to “make-do”. For this reason, nursing’s blessing is also its curse. With our nature to make do, we preserve the status quo. We miss out on opportunities that capitalize on the value that the nursing model truly offers.
How do we elevate NP practice owners to risk takers and valued participants in VBP? What creates enough incentive for NP practice owners to color outside the lines of FFS? How do we leverage what we know about how nurses problem-solve to produce informed risk takers?
These are the very questions we will confront together at NNPEN’s NP VBP Virtual Summit on February 11th and 12th. These are questions we must answer; our time is NOW. So here’s my first message as NNPEN’s CEO to Nurse Practitioner practice owners and the resources that support them:
BE A PART OF THE START!! Join the Summit's payment conversation and post-Summit building of road maps to nurse-led practice sustainability; we need you NOW! Here’s the Summit information link: CLICK
Dr. Lynn RapsilberCo-founder and CEO NNPEN