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Role of nurse practitioners in caring for patients with complex health needs
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Fraze, Taressa K., Briggs, Adam D. M., Whitcomb, Elizabeth K., Peck, Kristen A. and Meara, Ellen (2020) Role of nurse practitioners in caring for patients with complex health needs. Medical Care, 58 (10). pp. 853-860. doi:10.1097/MLR.0000000000001364 ISSN 0025-7079.
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Official URL: http://dx.doi.org/10.1097/MLR.0000000000001364
Abstract
Objective:
To estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012-2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse practitioners varies by practice characteristics.
Design:
Observational study of 2012-2017 Medicare fee-for-service beneficiaries’ ambulatory visits. We computed the percentage of beneficiaries with one or more ambulatory visits from nurse practitioners and the percentage of beneficiaries receiving the plurality of their ambulatory visits from a nurse practitioner versus a physician (i.e. predominant provider). We compared beneficiary demographics, clinical characteristics, and utilization by predominant provider. We then characterized the predominant provider by practice characteristics.
Key Results:
In 2017, 28.9% of beneficiaries received any care from a nurse practitioner and 8.0% utilized nurse practitioners as their predominant provider – an increase from 4.4% in 2012. Among beneficiaries cared for by nurse practitioners in 2017, 25.9% had three or more chronic conditions compared with 20.8% of those cared for by physicians. Beneficiaries cared for in practices owned by health systems were more likely to have a nurse practitioner as their predominant provider compared with those attending practices that were independently owned (9.3% vs. 7.0%).
Conclusions:
Nurse practitioners are caring for Medicare beneficiaries with complex needs at rates that match or exceed their physician colleagues. The growing role of nurse practitioners, especially in health care systems, warrants attention as organizations embark on payment and delivery reform.
Item Type: | Journal Article | ||||||||||||
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Subjects: | R Medicine > RT Nursing | ||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Nurse practitioners, Caregivers, Primary care (Medicine), Nurse and patient | ||||||||||||
Journal or Publication Title: | Medical Care | ||||||||||||
Publisher: | Lippincott Williams & Wilkins | ||||||||||||
ISSN: | 0025-7079 | ||||||||||||
Official Date: | October 2020 | ||||||||||||
Dates: |
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Volume: | 58 | ||||||||||||
Number: | 10 | ||||||||||||
Page Range: | pp. 853-860 | ||||||||||||
DOI: | 10.1097/MLR.0000000000001364 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||
Date of first compliant deposit: | 5 May 2020 | ||||||||||||
Date of first compliant Open Access: | 17 September 2020 | ||||||||||||
RIOXX Funder/Project Grant: |
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