Capturing reimbursement for advanced practice nurse services in acute and critical care: legal and business considerations.
Advanced practice nurses (APNs) have been affected positively and negatively by recent changes in the way hospitals are financed. Among these changes are the shift from cost-based reimbursement to a prospective payment system and increased opportunities for billing APN services under the physician payment system. Positive effects include the need for hospitals to decrease the length of stay of hospitalized patients, leading to jobs for APNs who make the hospital course and discharge more efficient. Negative effects include budget shortfalls that lead to layoffs. This article explains the current financial landscape, including phenomena that are impeding the billing of APN services, and recommends adjustments so that the APN role will be on firm financial footing.
Buppert
Carolyn
C
Law Office of Carolyn Buppert, PC, Annapolis, MD, USA. Cbuppert@buppert.com
D000208:Acute Disease / Q000451:nursing*; D000465:Algorithms; D002017:Budgets; D003362:Cost-Benefit Analysis; D003422:Critical Care; D003663:Decision Trees; D017598:Efficiency, Organizational; D006301:Health Services Needs and Demand; D006739:Hospital Administration / Q000191:economics / Q000592:standards; D006801:Humans; D007902:Length of Stay; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration*; D024802:Nurse's Role; D017009:Professional Autonomy; D012051:Reimbursement Mechanisms / Q000458:organization & administration*; D014481:United States