The National Association of Pediatric Nurse Practitioners (NAPNAP) recognizes the comprehensive, cost-effective, and high-quality health care services that nurse practitioners (NPs) deliver to patients. NPs are recognized as licensed providers of primary, specialty and acute care. They have demonstrated the ability to provide high-quality health care and incur the same overhead costs as physicians, according to an updated position statement from NAPNAP released in the Journal of Pediatric Health Care. NAPNAP calls for NPs to be reimbursed at a comparable level to physicians for the services they deliver across all health care settings.
In the statement, NAPNAP stresses NPs’ ability to demonstrate the outcomes related to the care they provide is critical to supporting changes in coverage and reimbursement rules. This is often hard to track because third-party payers often require that NP services be billed under a physician’s name and provider number. This practice makes it difficult for NP care delivery to be accurately documented.
“By ensuring equitable reimbursement practices, the contributions that NPs make to our health care system will be fairly recognized and compensated,” said NAPNAP President Jennifer Sonney, PhD, APRN, PPCNP-BC, FAANP, FAAN. “It is particularly important to close the reimbursement gap because evidence shows that NPs are essential to enhancing access to care for underserved populations across the U.S.”
To optimize NP reimbursement, NAPNAP believes all NPs must obtain their own national provider number and Drug Enforcement Agency number. In addition, states with barriers that reduce or restrict NP practice are urged to pass legislation that grants full practice to NPs which would facilitate equitable reimbursement and innovate business models for health care delivery. NAPNAP also advocates for direct reimbursement for NP services and equal reimbursements for all health care providers when performing the same service.
To further improve reimbursement parity, recommendations include legislation and policies that require state and federal programs to reimburse all health care providers equally, value-based payment or other payment models that focus on equity and inclusion of NPs on commercial and other payers’ advisory and credentialing committees. Finally, it is essential for transparent reporting of quality and outcome data for individual providers to better track and quantify health care measures.
The position statement, including additional recommendations, is published in the November/December edition of the Journal of Pediatric Health Care and can be accessed here.
Dec. 20, 2022
