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Reducing Barriers to NP Value-Based Care

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Reducing barriers to ensure nurse practitioner-owned practices can participate and thrive as US health care shifts to value-based payment structures


The US health care system is changing the way it pays for health care, rewarding value over volume. While this is the right direction, there are barriers to this type of reimbursement, especially for the increasing numbers of nurse practitioner (NP)-led practices. For small, independent, NP-owned practices, the transition to value-based reimbursement can pose significant financial risks. Tools to understand and mitigate the risks of value-based care are often not accessible or are designed for physicians.

What we are doing

Boston College and its partners, Brandeis University, and the National Nurse Practitioner Entrepreneur Network, seek to reduce barriers to value-based payment arrangements for NP-owned practices. The pilot will develop a NP Practice Risk Readiness Development Model, which includes a tool to identify areas to improve practice risk readiness and a learning collaborative program. The model offers NP practices an opportunity to overcome challenges to risk readiness, ultimately facilitating more value-based payment contracts. The project will train other NP practice networks to replicate the model and bring individual NP practices together to build collective power for payer negotiation.

Monica O'Reilly-Jacob Assistant Professor, Boston College Cornell School of Nursing
We conducted a survey and found only a quarter of nurse practitioner practices participate in value-based payment contracts. Many are ineligible due to insufficient patient volume or other payer rules. However, these practices often intentionally stay small so that they can form better patient-provider relationships. This project aims to find a path for these critically needed NP practices to flourish within a changing health care payment landscape.


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