Nurse Practitioners at SNFs as huge health reform tool

[3rdcareerRN]

I just ran across a concept that I'd never considered (I'm an RN, not an NP, but interested in health reform):

UnitedHealth has proposed: "onsite nurse practitioners at skilled nursing facilities to manage illnesses and prevent avoidable hospitalizations." with projected U.S. savings of ~$166 billion [2010-2019 period]"

http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper1.pdf

This seems like such a good concept at first glance. Obviously the reimbursement elements must be addressed, and some coordination established between the NP and the patients' PMP. But avoiding unnecessary hospitalizations and providing care-in-place seems to make so much sense...and it could be a HUGE opportunity for NPs.

Your thoughts?

(cross posted to NP forum)

[LHH1996]

absolutely agree...i actually joked with my DON and administrator the other day that i would love to become a NP and work where i work to do that. as an Mds coordinator i bugs me how many times we send people to hospitals for things that i know we could have treated at the nursing home. this actually makes us money in the long run with increased medicare reimbersment and higher case mix. Also the aspect of "bothering" the medical doctors and clinical NP's to come in and see the patients is not very convenient on either side. so having one employeed would be great in my opinion. i have heard that some places do that.

[CoffeeRTC, BSN, RN]

I've worked in a few places that had NPs. It did save a lot of hospital trips and it was soooo easy to get treatments and care ordered.

I like this idea. I just wonder how profitable it could be for the NP?

[debRN0417]

I have been at a couple of places recently that have NP's- I think it is wonderful! The NP's are there every day, they see sick patients, do recerts, do wound rounds and all sorts of stuff. I think it is absolutely great! The residents seem to really like having their "nurse practicioner doctor" available to them because they NP is there everyday!

[achot chavi]

I think it will save on hospitalizations and it is a good idea,

[elkpark]

The only thing UnitedHealth is interested in is protecting and maximizing its own profits. When I was doing UR a number of years ago, they were the worst insurance co. to deal with.

[noc4senuf]

There is nothing new about this at all. We have done this for years. The NP's are in the buildings from 1-4 days a week depending on their case loads. It cuts down on any faxing to clinics etc. We actually have 3 different NP's (different clinics) that come to our facility.

[LHH1996]

We always have had Np's "come" to the facility also..i think the question was for the SNF to actually "employ" a NP...

[noc4senuf]

The article was regarding Evercare NP's. They are not employed by the facilities.

[florianslove]

We have an evercare NP in our facility, and I love dealing with her. In fact, the PCP usually tells us to call the NP. She is knowledgable and in most cases easier to deal with than the MD.

I also had an NP as a primary health care provider for a number of years (her husband was the MD), and loved her.

I love NP's and Phycisian Assistant's.

Roxann