The article chosen by the poster discusses the disadvantages of the incident to billing and the advantages of a value-based system of reimbursement. Rapsilber (2019) argues that the first approach makes NPs invisible, thus erasing their role in health delivery and crediting all quality-related efforts to physicians. As a result, NPs are not viewed as primary care providers. Then, the author suggests that a value-based strategy is much more effective than other models because it highlights the impact of NPs on practice and focuses on quality rather than resources used.
This idea is in line with the one discussed by Bellot et al. (2017), who believe that nurses, patients, and organizations benefit from treating NPs as primary care providers. While they view this question from the point of managed care organizations (MCOs), they come to a similar conclusion – NPs are an indispensable part of the healthcare system.
The issues analyzed in both articles reveal a set of underlying problems that NPs face in the legal and financial aspects of practice. Rapsilber (2019) and Bellot et al. (2017) note that nurses’ scope of practice regulations greatly limit these professionals’ ability to treat patients. Nurses who are not recognized as primary providers of care cannot advocate for themselves in full capacity. Moreover, they depend on their supervising physicians when trying to achieve a higher reimbursement rate.
For these reasons, the scholars behind both pieces of research urge government institutions to review NPs opportunities. They also suggest nurses seek a value-based, collaborative approach, where NPs work together to increase the level of autonomy, billing through their own means or contracts with MCOs. Overall, the conclusions of the articles agree with the increasing need to recognize NPs for their contribution.
References
Bellot, J., Valdez, B., Altdoerffer, K., Quiaoit, Y., Bronzell-Wynder, T., & Cunningham, P. (2017). Does contracting with managed care organizations remain a barrier for nurse practitioners? Nursing Economics, 35(2), 57-63.
Rapsilber, L. (2019). Incident to billing in a value-based reimbursement world. The Nurse Practitioner, 44(2), 15–17.