NR 510 Week 3 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
University:
Chamberlain University
NR 510 Week 3 Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
Paper Instructions
You are a family nurse practitioner (FNP) employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees).
The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could be helpful. Your contract is up for renewal in 3 months. You are highly satisfied with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend.
Discussion Question
What negotiation strategies should you use to propose a contract renewal? How does your role as a 1099 contractor benefit the practice over the W2 employees? What evidence will you present to the practice to reinforce your value in the practice both in terms of revenue and patient satisfaction?
Consider any additional services you may be willing to provide under your contract. Use logical reasoning, and provide evidence based rationales for your decisions.
Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.
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Sample Answer
Carolyn Buppert suggests using the three P’s when preparing for a contract negotiation (Danielsen, Potenza, and Onieal, 2016). The three P’s stand for prepare, probe, and propose. When the negotiation discussion begins I would start of by stating the number of patients seen for the year and the billable hours that were paid. According to the AANP the US average of NPs see 3 or more patients per hour. A goal to increase revenue would be to start scheduling 3 patients per hour.
According to Buppert’s payment model this will increase my revenues by more than $75,000 a year. As a contract employee I would be responsible to pay my own taxes, provide my own malpractice insurance, I would not receive medical benefits, and I would pay for my own continuing education, reducing my cost of employment to the practice. I would discuss patient satisfaction and new patient retention rates. An increase in these rates would show my value to the practice.
I would also discuss patient outcomes and the increase or decrease in non-scheduled hospital admissions. A goal to increase revenue would be to decrease no-show rates. Initiating a telephone engagement protocol as stated by Clouse, Williams, and Harmon (2015) has to ability to decrease no-show rates and increase revenues. To take strain off the physician, comanagement of patients could be recommended. Comanagement means the NP and the physician work together to manage the health care needs of the same patients.
Norful, de Jacq, Carlino, and Poghosyan (2018) state “the stronger comanagement is, the greater the potential for beneficial patient, clinician, and practice outcome” (p. 254). As the NP I could manage patient call backs of those with chronic illnesses that are being managed in extended care facilities.
Resources
- AANP. (2018). NP Fact Sheet. Retrieved from https //www.aanp.org/all-about-nps/np-fact-sheet.
- Clouse, K., Williams, K., & Harmon, J. (2015). Improving the no-show rate of new patients in outpatient psychiatric practice an advance practice nurse-initiated telephone engagement protocol quality improvement practice. Perspectives in Psychiatric Care, 53, 127-134.
- Danielsen, , R., Potenza, A. & Onieal, M. Negotiating the professional contract. Clinician Reviews,28-33.
- Decapua, M. (2016). How much revenue does a primary care nurse practitioner generate? Retrieved from https //www.bartonassociates.com/blog/how-much-revenue-does-a-primary-care-nurse-practitioner-generate/.
- Norful, A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician comanagement a theoretical model to alleviated primary care strain. Annals of Family Medicine, 16(3), 250-256.
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