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Nurses Rap Payment Models Recommended by AMA

John Commins, for HealthLeaders Media, November 20, 2013

"Many nurse-managed health centers see patients, diagnose them, treat them, manage them and write prescriptions without any involvement from physicians. If a reimbursement model requires physician leadership those nurse-managed health centers close and the patients who get their care at those sites can no longer get care."

Kopanos says it is well established that not all care regimens require a physician's input, which otherwise adds needless costs and wastes resources for an already short-staffed national healthcare workforce.

"Team-based care is centered on the needs of the patient and the providers who can best meet that care. We have a multitude of providers, nurse practitioners, pharmacists, physical therapists, behavioral health experts, who at certain times based on the needs of the patient may be the best ones to lead the team for what that patient needs," she says.

"When we artificially move the licensure or reimbursement to one particular profession we are shortchanging the patients' ability to get the provider they need and to utilize our workforce more efficiently to take care of patients."


John Commins is a senior editor with HealthLeaders Media.

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6 comments on "Nurses Rap Payment Models Recommended by AMA"


Jon Burroughs (11/24/2013 at 9:06 PM)
It is not either/or, it is and. In New Hampshire, nurse practitioners can work independently of physicians but choose to work collaboratively with them due to their interdependent skills and areas of expertise. One is not better than another; each brings different skills and perspectives that are equally valuable to the patient.

Brad Thornton (11/22/2013 at 8:23 AM)
Speaking as a long time nurse and less time Administrator I see mid-level and MD performance comparisons all day long. There is a constant and predictable difference in outcomes and costs in favor of the MD. However, this "clinical" competence does NOT make them a strong leader, nor does it make them effective in their management of staff or mid-levels. My experience says we need some degree of mid-level oversight but, of equal importance in the process, physicians must learn leadership and management skills....bt

Jeff angel (11/22/2013 at 4:22 AM)
Let me sum up a physician versus mid-level: depth and breadth of training, not to mention rigors of training that weed out the lazy and the ones who cannot think when tired, etc I see unnecessary tests and wrong treatment plans by midlevels nearly everyday. Like it or not, there is a big difference in training. Studies have shown midlevels order more tests/have higher costs. There is nothing wrong with supervision and collaboration. Its better care and nothing but jealousy to not want help!! Lets work together...with appropriate supervision by leaders who have more training.