title: Collaboration, not competition: cost analysis of neonatal nurse practitioner plus neonatologist versus neonatologist-only care models.
abstract: BACKGROUND
  Although advanced practice in neonatal nursing is accepted and supported by the American Academy of Pediatrics and National Association of Neonatal Nurse Practitioners, less than one-half of all states allow independent prescriptive authority by advanced practice nurse practitioners.
  
  
  OBJECTIVE
  The purpose of this study was to compare costs of a collaborative practice model that includes neonatal nurse practitioner (NNP) plus neonatologist (Neo) versus a neonatologist only (Neo-Only) practice in Washington state. Published Internet median salary figures from 3 sources were averaged to produce mean ± SD provider salaries, and costs for each care model were calculated in this descriptive, comparative study.
  
  
  RESULTS
  Median NNP versus Neo salaries were $99,773 ± $5206 versus $228,871 ± $9654, respectively (P < .0001). The NNP + Neo (5 NNP/3 Neo full-time equivalents [FTEs]) cost $1,185,475 versus Neo-Only (8 Neo FTEs) cost $1,830,960. The NNP + Neo practice model with 8 FTEs suggests a cost savings, with assumed equivalent reimbursement, of $645,485/year.
  
  
  CONCLUSIONS
  These results may provide the impetus for more states to adopt broader scope of practice licensure for NNPs.
  
  
  CONCLUSIONS
  These data may provide rationale for analysis of actual costs and outcomes of collaborative practice.
authors.affiliation: Pediatrix Medical Group, Renton, Washington, and Family/Child Nursing Department, University of Washington, Seattle.
authors.forename: Elena
authors.initials: E
authors.lastname: Bosque
mesh_terms: D057179:Advanced Practice Nursing / Q000191:economics* / Q000458:organization & administration; D003299:Cooperative Behavior; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000191:economics* / Q000458:organization & administration; D017283:Neonatal Nursing / Q000191:economics* / Q000458:organization & administration; D009359:Neonatology / Q000191:economics* / Q000458:organization & administration; D012456:Salaries and Fringe Benefits / Q000191:economics*; D014861:Washington