Historically, reimbursement for NP services
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Historically, reimbursement for NP services
Instructions: Respond by extending, refuting/correcting, or adding additional nuance. Response must be constructive, grammatically correct, in current APA style, and use academic literature. Must be at least 300 words.Advanced practice registered nurses are knowledgeable, educated, well trained and able to provide a plethora of services to patients. That being said, there are several barriers that have hindered the progress of advanced practice nursing including federal policies, outdated insurance reimbursement practices and institutional practices and culture within the workplace (Altman, 2016).
Although progress has been made, there are still numerous federal policies that prevent APRNs from practicing to the full extent of their training and education. In 2018, Congress issued legislation that made it possible for nurse practitioners (NPs) to oversee pulmonary and cardiac rehabilitation beginning in 2024, however NPs are still not able to order pulmonary and cardiac rehabilitation for their Medicare patients (AANP, 2021). Nurse Practitioners are both capable and qualified to provide these services, however this barrier only services to harm patients as it causes delays in treatment. Secondly, although (NPs) provide full range of care to individuals affected by Diabetes, they are still required to involve a physician when a patient requires therapeutic shoes. The NP must send the patient to a physician to confirm the need for the shoes, and the physician then must be tasked with being the provider treating the diabetics condition moving forward. Again, this causes major delays within the healthcare system and affects the overall health of the patient (AANP, 2011). Additionally, while NPs work as providers for hospice patients and are able to conduct assessments as well as establish and review care plans, they are prohibited from certifying eligibility for hospice programs. Once again, a physician is required, and additional costs are incurred. Currently, the American Association of Nurse Practitioners is calling on Congress to change many federal laws, including authorizing NPs to order cardiac and pulmonary rehabilitation services for Medicare patients, allowing for NPs to issue therapeutic shoes to diabetics without involving a physician and authorizing NPs to certify Medicare patients for Hospice Care (AANP, 2011).
Historically, reimbursement for NP services has been scattered and confusing to say the least. In 1990, APRN direct reimbursement by Medicare was available only in rural areas and skilled nursing facilities. It was not until 1997 that direct reimbursement was made possible in all clinical settings as well as locations, however the rate was 85% of that of a physician. (Journal of Wound, Ostomy and Continence Nursing, 2012). This can be a huge issue, as NPs working in their own offices receive 15% less reimbursement than a physicians office would. Furthermore, there is so much variability in Medicaid reimbursement between different states at a time when nurse practitioners are expected to take care of record numbers of patients utilizing Medicaid. Medicaid tends to follow federal guidelines as it relates to reimbursement, therefore the problem with a reduction in payment to nurse practitioners for service charges that are already exceptionally low is extremely significant (Edmunds, 2014). To combat this, nurse practitioners are bringing this to the federal level, and asking that NPs be reimbursed at the same rate as physicians when caring for Medicaid patients.
Another barrier to the progress of advanced practice nursing is the culture of many settings where physicians and NPs interact on a daily basis. Although NPs possess the specific skillsets to diagnose, prescribe and treat, there is often physician opposition to independent NP practice, which is free from oversight or supervision (Schirle, et.al, 2018). There is also a major lack of understanding of the NPs role, and lack of recognition on a professional level. Studies have shown that NPs report lower job strain and increased job satisfaction when given higher levels of autonomy rather than being micromanaged (Schirle, et. al,2018). To manage this widespread issue, relationships between NPs and physicians should be improved and there should be more education provided as to the scope of the NPs role. Further, the NP should be treated with respect and professionally recognized for the services that they provide on a daily basis. Lastly, an appropriate amount of autonomy should exist for NPs to utilize their knowledge, educations and skillsets. By doing this, job satisfaction and productivity is increased, and patients are cared for by an NP that feels valued in the workplace.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
CLICK ON THE LINK HERE: https://www.perfectacademic.com/orders/ordernow
Also, you can place the order at www.collegepaper.us/orders/ordernow / www.phdwriters.us/orders/ordernow
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME]and Have It Done by Our PhD Qualified Writers!!