Understanding managed care: practice implications for NPs.
Highly effective nurse practitioners in managed care settings may understand the basic concept of managed care without appreciating how the context of managed care impacts their practice. This article discusses the concept of managed care within the context of 4 managed care strategies. In developing this paper, our goals were first, to describe contracts, incentives, management, and medical necessity as managed care strategies and second, to discuss some of the ways these strategies can significantly impact nurse practitioner practice. Illustrative practice examples are used to suggest that those nurse practitioners who understand managed care, both as a theoretical concept and as a context for practice, may find that they are better able to develop innovative ways to meet the needs of their patients.
Baik
S Y
SY
University of Wisconsin-Madison School of Nursing, Madison, WI, USA. seongyi.baik@uc.edu
Oakley
L D
LD
Hoebeke
R
R
Dunham
N C
NC
D006801:Humans; D019458:Insurance Coverage; D007349:Insurance, Health, Reimbursement; D008329:Managed Care Programs / Q000458:organization & administration*; D009722:Nurse Practitioners; D012052:Reimbursement, Incentive; D014481:United States