Question

Question: How can I counter-argue this viewpoint? (general summary or thoughts of this post for a debate)

                The Nurse Practitioners not being independently contracted makes getting their reimbursement more difficult (Does Contact with Managed Care Organizations Remain A barrier for Nurse Practitioners? 2017). This isn’t the ideal way for their reimbursement as they would probably just be on a salary, and not get compensated for all their visits. Such a high percentage of Managed Care Organizations not contracting with Nurse Practitioners as primary care providers has a negative implication for the Affordable Care Act’s goals of increasing access, lowering cost, and enhancing quality (Does Contact with Managed Care Organizations Remain A barrier for Nurse Practitioners? 2017). The demand for physicians continues to increase. I have worked in many facilities, and from my experience Nurse Practitioners are so helpful to have in a facility to help with volume and overflow of visits. This is something that should be granted more. Nurse Practitioners are extremely qualified and deserve recognition as well.

Not having professionally contracted nurse professionals makes it more difficult to seek compensation(Does Contacting with Managed Care Organizations Remain A barrier for Nurse Practitioners?, 2017). This is not the best way to pay their money, because they possibly will not be charged all their trips. This will not be rewarded. This high degree of Managed Care Agency non-contracting as primary health care providers has a significant effect on the targets of the Affordable Care Act to expand coverage, cut costs and increase quality (Does Contact with Managed Care Organizations Remain A barrier for Nurse Practitioners?, 2017). The need for doctors is also rising. I have served in several hospitals and I will support nurses in a facility with the frequency and overflow of patients due to my training. This is much else to be offered. Practitioners are exceptionally trained and should be remembered.

reference:

Does Contacting with Managed Care Organizations Remain A barrier for Nurse Practitioners? (2017). Nursing Economics, 7.

Answer 1

I
N ITS FIRST YEAR of implemen-
tation, the Affordable Care
Act (ACA) increased the num-
ber of insured by an estimated
8-11 million, decreasing those
uninsured in the United States by
25%. Further, as state Medicaid
expansion programs roll out, sev-
eral million more Americans are
expected to obtain health insur-
ance coverage. In light of the
increase of insured Americans, it
is estimated that, in 2020, there
will be a shortage of 45,000 pri-
mary care physicians (Kirch,
Henderson, & Dill, 2012). Nurse
practitioners (NPs) have the abili-
ty, if utilized to the full scope of
their practice, to close this
provider gap (Bauer, 2010; Cro-
nenwett & Dzau, 2010; Kirch et al.,
2012; Poghosyan, Lucero, Rauch,
& Berkowitz, 2012).
Inability to contract with man-
aged care organizations (MCOs),
defined simply as health insurers
or third-party payers, is a barrier
for NPs (Hansen-Turton, Ritter, &
Torgan, 2008). Sustainability of
NP-led primary care relies on
MCOs contracting with NPs as pri-
mary care providers (Hansen-
Turton, Ritter, Begun et al., 2006).
Without contracting, NPs cannot
be compensated sufficiently for
care provision.
Managed care contracting is
not solely driven by state practice
acts and contracting policies can
vary between different insurance
plans within a state. Individual
MCOs determine their policy for
NP contracting depending on the
market’s demand for providers,
which is highly variable (Hansen-
Turton, Ritter, Begun et al., 2006).
This study provides a comprehen-
sive survey of MCO contracting
practices relating to NPs, differen-
tiating by product plans that are
offered on the state and federal
insurance exchange marketplace.