Wednesday, February 22, 2012

Oregon: Health Care Politics at Play

I've been following plight of the Oregon Nurse Practitioners regarding reimbursement rates. It seems that back in 2009, NP reimbursement rates from insurance companies were arbitrarily cut by up to 55% for no apparent reason. An attempt to correct that was introduced in the form of legislation. While it appears that the bill itself contained some flaws, it is now destined to flounder in committee once again.

The sad thing here is politics at play. Heavy lobbying from the insurance companies and from organized medicine guaranteed the bill's demise. The lobbyists relied on the "costs will go up" tagline to shoot down the bill. This is laughable. Did those who were insured costs go down when they saw a nurse practitioner? Nope. The NPs diagnosed and treated the patients as they were educated and trained to do - not from some alternative medicine crack pot cookbook. It came from recognized health care standards, procedures, and guidelines. Yet, the insurance companies want to reimburse NPs less for the same work done and reap the rewards. Not fair.

I am not debating the whole physician versus nurse practitioner compensation argument here - we can save that for another time. This reaks of greed and is putting patient lives at risk - especially those in rural areas where these NPs are practicing and are often the sole provider in that area. Unfortunately, it seems as if this practice will continue unabated and those having the power to do something about it will sit idle and hope that maybe someone else will pick up the slack.

Tuesday, February 7, 2012

Advancing Nurse Practitioner Practice

I saw 2 notable articles in the news last week about nurse practitioner practice that I wanted to share. The first one is about two new bills introduced in Missouri that would eliminate the collaborative practice requirement between a nurse practitioner and physician and would allow NPs to prescribe controlled substances as indicated. Missouri is one of the most restrictive states when it comes to NP practice and if this legislation passes, they will move to the forefront of of autonomy. They will have substantial opposition but the bills would allow these NPs to practice to the full extent of their training and education. 

The other article is about the first nurse practitioner to practice in Bermuda. She will begin this summer and work in King Edward VII Memorial Hospital. She is scheduled to be the first student to complete their NP program. 

It is great to see NP practice evolve and have regulations that reflect a scope of practice that is congruent with the training and education of NPs. While there is much work to do (just look at some of the comments from the 1st article), it is becoming clear that NPs can make a meaningful difference in the health care landscape caring for patients.