Can advanced practice nurses succeed in the primary care market?
In the mid-1980s the Columbia University School of Nursing (CUSN) reconfigured its mission to once again become the premier training ground for clinical experts in nursing. Its APN faculty members were expected to function as APN primary care providers in some of its affiliated clinics. Extensive studies at CUSN have validated the high quality and effectiveness of comprehensive APN-managed patient care when compared to a randomly selected group of patients managed by primary care MDs. The issue of APN-MD primary practice fee equity for professional services at Columbia Presbyterian Medical Center was settled by agreement to the same reimbursement per visit, while acknowledging that APNs would customarily have longer contact time with each patient, and therefore a lower number of visits per day. The studies concluded that the ideal configuration of professional health care services would see APNs with hospital admitting priviledges alongside primary care and specialty MDs working collectively to serve their patients together in the new system.
Mundinger
M O
MO
Columbia University, School of Nursing, New York, NY, USA.
D004511:Education, Nursing, Graduate / Q000458:organization & administration; D006801:Humans; D008389:Marketing of Health Services / Q000458:organization & administration*; D009518:New York; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration*; D011320:Primary Health Care; D012051:Reimbursement Mechanisms / Q000458:organization & administration*; D015895:Relative Value Scales; D012456:Salaries and Fringe Benefits; D000078329:Workforce