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Filling the Gap Wisely
Nurse Practitioner Workforce healthcare spending is currently around 17.0% of PGDP, but more importantly, annual increases in healthcare spending reached all time lows in 2009 and 2010. In fact, annual increases in healthcare spending declined from 10% to 4% between 2002 and 2008 and have stabilized between 4% and 6%. These findings suggest that U.S. healthcare spending relative to the consumer price index (CPI), an accepted measure of inflation, had stabilized by 2008 and has been only 1-3% above the CPI since (Inflation.eu, 2013).
There is no question that healthcare costs have been weighing heavy on policy makers, especially with an aging 'baby-boom' generation and passage of the Patient Protection and Affordable Care Act (ACA) of 2010. Total national spending on healthcare was estimated to have exceeded $2.8 trillion in 2012, which represented 17.9% of the gross domestic product (GDP) (Turner and Hughes-Cromwick, 2013). Given its current trajectory, healthcare spending could reach $4.8 trillion by 2021 and consume nearly 20% of GDP (CMS, n.d.).
However, not everyone considers healthcare spending to be out of control. Rather than rely solely on percent GDP, Turner and Hughes-Cromwick (2013) looked at spending as percent potential GDP (PGDP). PDGP is considered a better long-term reference for economic trends because it minimizes fluctuations caused by short-term changes in inflation. Based on this
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Using out-of-control healthcare costs as an argument for increasing the role of nurse practitioners (NPs) may not be sufficiently convincing in light of the above findings. Another argument that has received some attention is an increasing physician shortage (Bell, 2012). A recent policy recommendation by the Association of American Medical Colleges (AAMC, 2012) predicts that unless Congress enacts emergency legislation to remove the annual cap on residency training, the additional 300 positions funded under the ACA cannot meet the additional 10,000 needed to meet the demand. With 32 million Americans suddenly becoming eligible for healthcare coverage under the ACA and an aging 'baby-boom' generation, the doctor shortage is expected to reach 91,500 by 2020.
In 2010 there were approximately 106,000 NPs in the U.S., of which 52% were working in primary care (AHRQ, 2011). By comparison, there were approximately 560,000 primary care physicians (BLS, 2012a). Since numerous studies have found that NPs provide care quality equivalent to physicians (Newhouse et al., 2011), the looming physician gap could be moderated by an increase in the size of the NP workforce.
Increasing the NP workforce to minimize the effects of the doctor shortage would also have economic…
Newhouse, Robin P., Stanik-Hutt, Julie, White, Kathleen M., Johantgen, Meg, Bass, Eric B., Zangaro, George et al. (2011). Advanced practice nurse outcomes 1990-2008: A systematic review. Nursing Economics, 29(5), 230-250.
Pronsati, Michelle Perron. (2012). National Salary Report 2011: A dramatic drop in PA salary, but just a dip for NPs. Advance for NPs & PAs, Merion Matters. Retrieved 26 Mar. 2013 from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/National-Salary-Report-2011.aspx.
Turner, Ani and Hughes-Cromwick, Paul. (2013). Connecting U.S. health expenditures with the health sector workforce. Business Economics, 48, 42-57.
The NP emphasizes health promotion, while, particularly in North America, the MD primarily focuses on disease treatment. The role of the NP and the MD are simultaneously similar yet differ from each other. Consequently, no reason supports the contention that one group must be dependent and the other dependent. "Measuring NP performance against the physician (or any other group) as the gold standard is inappropriate because the philosophical approach
Nursing: Today and Throughout History The occupation of nursing has been around for almost all of history in some form or another. In the ancient Roman Empire are found records of the nursing practice, where nurses provided care to in-patients at local Roman hospitals. In Constantinople—the Rome of the East—nurses were “known as hypourgoi” (Kourkouta, 1998). These nurses (both male and female) were tasked with jobs much like today’s nurses: they
Reducing Nursing Turnover by Implementing Innovative E-Health: A New Strategy for Incentivizing Nurses and Improving Organizational Culture Problem Identification: Nursing turnover rates are a serious issue for hospitals: they are costly and result in lost time and energy in continuously training new staff (Twibell, 2012). Identifying the main reasons for nursing turnover and addressing them can lead to better nurse retention (Trivellas, Gerogiannis, Svarna, 2013). The problem of nurse retention has been identified
Introduction One of the main objectives of the Office of Disease Prevention and Health Promotion’s Healthy People 2020 campaign is to increase access to care for patients (ODPHP, 2018). However, with more and more primary care physicians leaving primary care for specialized medicine, there is a gap in care coverage. That gap could be filled if advanced practice registered nurses (APRNs) were permitted to practice to the full extent of their
Cross-Sectional Study to Determine Factors in the Educational Advancement of the Licensed Practical Nurse to the Registered Nurse in the State of North Carolina According to the Harvard Nursing Research Institute, United States nursing school enrollments dropped by 20.9% from 1995 to 1998 (Healthcare Review, 2000). Behind headlines such as this one are the overwhelming issues which threaten the nursing workforce: 1) staffing cuts, 2) mandatory overtime, and 3) the
Entrepreneurship: Nurse-Owned Clinics and Beyond Mobile FNP (Family Nurse Practitioners) There are over 125,000 NPs (nurse practitioners) in the U.S., as per estimates of the AANP (American Academy of NPs). Compared to physician assistants, NPs enjoy greater autonomy and responsibility, and have been increasingly assuming roles in administrative leadership, aside from their conventional patient-care duties at clinics and hospitals. However, owing to the thorough knowledge required to succeed within private practice