Systematic review addressing nurse practitioner reimbursement policy: Part one of a four-part series on critical topics identified by the 2015 nurse practitioner research agenda.

Background and purpose: The growth and sustainability of nurse practitioners (NPs) requires transparent, fair and equitable reimbursement policies. Complicating this issue is variation in reimbursement policy within and across federal, state, and other payers. Even with explicit regulations, there r...

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Publicado en:Journal of the American Association of Nurse Practitioners Vol. 30; no. 12; pp. 673 - 683
Autores principales: Harkless, Gene, Vece, Loretta
Formato: CEU research systematic review tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2018
      vid: 30
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Systematic review addressing nurse practitioner reimbursement policy: Part one of a four-part series on critical topics identified by the 2015 nurse practitioner research agenda.
      aug:
        au:
          Harkless, Gene
          Vece, Loretta
        affil: Department of Nursing, University of New Hampshire, Durham, New Hampshire; AANP Research Committee
      sug:
        subj:
          Insurance, Health, Reimbursement
          Health Policy
          Nurse Practitioners
          Human
          United States
          Education, Continuing (Credit)
          Systematic Review
          Medline
          CINAHL Database
          Cochrane Library
          Medicaid
          Scope of Nursing Practice Legislation and Jurisprudence
          Discrimination, Employment
          Credentialing
          Contracts
          Health Insurance Exchanges
          Research, Nursing
      ab: Background and purpose: The growth and sustainability of nurse practitioners (NPs) requires transparent, fair and equitable reimbursement policies. Complicating this issue is variation in reimbursement policy within and across federal, state, and other payers. Even with explicit regulations, there remain questions on how reimbursement policies are covertly operationalized in practice. This systematic review aims to identify knowledge gaps related to reimbursement policy issues and outlines recommendations for further research. Methods: Eight major databases were searched using terms including "nurse practitioner," "reimbursement," "policy," and "research," limited to the United States and inclusive of December 2006-September 2017. Articles meeting the inclusion criteria were analyzed for themes and gaps. Conclusion: The final review includes 17 articles identifying themes including state-determined Medicaid reimbursement and scope of practice legislation shapes NP clinical practice; NPs as identified primary care providers: credentialing and contracting; reimbursement parity; and "incident to" billing. Moreover, there is evidence of discriminatory policies that disadvantage NPs and limit their access to patients, direct billing, and direct reimbursement. Implications for practice: Future research needs to focus on outcomes of discriminatory, as well as supportive, reimbursement policies in organizations, and their influence on patient access and quality care.
      pubtype: Academic Journal
      doctype:
        CEU
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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