Singleton says the appeal of non-physician providers is obvious, starting with the fact that compensation for NPs and APs is about one-third that of physicians, "and maybe even a little bit less."
Tallying the Cost Advantages
But that's just for starters. "Where you are starting to see the real cost advantage is in the fully functioning co-management type of world," Singleton says.
"There is this spectrum of duplication where the physician and the nurse practitioners are doing too many of the same things. On the other end of the spectrum you are maybe allowing the nurse practitioner to do too many things and you have a problem with continuity of care. If you find that middle range ratio in your medical group – most people will tell you it's about two NPs to one primary care physician—then the cost efficiencies are incredible."
In a well-coordinated practice, Singleton says, the non-physician providers are seeing "the coughs and sniffles and things an MD probably shouldn't be handling on the front line anyway. So, you are able to see two and three times the production you would see out of one MD and you are getting better care because this allows the NPs to spend more time with the patients who fall under their scope of care while allowing the MD more time with more chronic or complex patient."