Calculating the Worth of the NP assignment

Advanced Practice Columnist / Guide · Feb 24

If your assignment is to figure out how your organization utilizes NP's, I think you have to do the legwork and make calls and establish contacts within your organization. If you work in a hospital, can you ask the NP's there if they can point you to the department or director who can answer these questions? clinics also have a practice manager who I'm pretty sure can answer these easily. As a practicing NP, I can easily give you my answers based on our organization but that seems a bit too "spoonfeeding" in a way especially for a student pursuing a doctoral degree.

96MaxLeo · Feb 25

Hi

Thank you for your quick response.
I have reached out to several colleagues within the hospital where I work. I was surprised to discover that none of them could confidently answer the questions. I asked nurse practitioners who provide direct care. I asked a nurse practitioner leader. She manages the inpatient nurse practitioners. I asked her direct report who is the AVP over the department. I've asked the manager and medical director of preadmission testing and the staff there. I also asked our CFO and an AVP of outpatient clinics. One of the responses was that when one of the nurse practitioners was out on FMLA on this particular inpatient floor, the length of stay went up because there was only one NP for 30 patients. None could give me concrete guidelines for measuring their work and efficiency. How do they know their need to add an FTE or subtract? I plan to compare and contrast the budget and how we measure staff nurses' needs. I have all of that information. I have done all of this in person emails and phone calls. I have also called my primary care provider's office and sent an email, and I'm waiting to hear back. This post was my last resort, not my first.

I'm sure I could get the answers from the web by searching, but I really want a nurse.peacticioner's perspective. I have all of my information regarding staff nurses, the budget, staffing calculations, when the daily census is measured , hours per patient per day calculations. there is no spoon feeding here. I'm doing the leg work. As I said in my the original post. I am having trouble getting the information from my organization and was seeking help.

Thank you

Advanced Practice Columnist / Guide · Feb 25

What state are you in? I know some of the answers to your question as far as where I work but not the fine details. We have an office of Advanced Practice that oversees all NP's, PA's, CNM's, and CRNA's. There is a director in charge of that office.

Does the hospital or practice unit measure the NP's productivity? yes, through RVU's but recently the state implemented a survey of non-billable services that providers offer in the hospital and clinics in an attempt to capture work that is not compensated (care coordination, training of new staff, etc). We are currently involved in this survey of provider productivity that is not billable.

How are these calculated CPTs, billable collections, and RVUs?

This I can't answer, the office of Advanced Practice would be able to.

Does the NP work in a group? How is the work distributed, calculated, or monitored?

We're all part of the medical center as an APP group. Various departments and sub-divisions have hired APP's based on need and patient volume. The Office of Medical Affairs and Governance (I.e., physicians) typically express an interest in adding APP's to their practice and an analysis of need is started. They work closely with the Office of Advanced Practice to create a position and start a job posting. It can take forever for a position to be approved as this is a large academic institution that is state-funded. Patient assignments vary, some services have a cap on patient census.

How is the compensation determined?

Union contract

Does the NP work under contract?

Union membership determines contract

Is the NP a hidden provider?

No

I can direct you to our Office of Advanced Practice by PM if you're interested.

96MaxLeo · Feb 26

Corey Narry said:

What state are you in? I know some of the answers to your question as far as where I work but not the fine details. We have an office of Advanced Practice that oversees all NP's, PA's, CNM's, and CRNA's. There is a director in charge of that office.

I can direct you to our Office of Advanced Practice by PM if you're interested.

Hi

I am in Pennsylvania. I am interested in contacting the Advance Practice Office. Can you PM me with the information? I tried to PM you, but I am not able to because I do not have 15 posts. Thank you so much for your help.

Trauma Columnist · Feb 27

I don't work in a hospital, but rather for a large private practice nephrology group.

Does the hospital or practice unit measure the NP's productivity? Yes, very closely. We bill for office visits under our names. We code the visits manually. We also see hemodialysis pts in hemodialysis units and this is a bundled payment determined by CMS.

How are these calculated CPTs, billable collections, and RVUs? We don't use RVUs but rather the number of pts seen.

Does the NP work in a group? How is the work distributed, calculated, or monitored? We are a large practice and have a director of APRNs. Work is distributed loosely on who lives where (we cover approx half the state), the number of pts seen and the experience of the provider

How is the compensation determinED? Basic cost of living raise each year, then productivity bonus as well

Is the NP a hidden provider? Nope

Home Health Columnist / Guide · Feb 27

Using search term "Calculating Nurse Practitioner value to a practice" several articles of interest including:

Calculating Your Worth: Understanding Productivity and Value

How Much Is A Nurse Practitioner Worth?

Book: Carolyn Buppert RN JD Nurse Practitioner's Business Practice and Legal Guide includes clinical performance measures