BARRIERS FOR ADVANCED PRACTICE NURSING.
Barriers for Advanced Practice Nursing
Barriers that have slowed down the progress of advanced practice nursing and strategies to help overcome these barriers
Outmoded reimbursement policies influence the daily practice of advanced nurses (APNs) and possibly prevent safe and accountable care.BARRIERS FOR ADVANCED PRACTICE NURSING.
According to Poghosyan (2018), there is variation in Medicare reimbursement rates for APNs and physicians, with APNs being reimbursed only eight-five percent of services delivered. In some states, APNs are required to bill incident to the physician’s services, meaning that the billing for delivery of care is under the name of the physician. The Centers for Medicare and Medicaid necessitates that the physician sets up the initial care plan and the APN undertakes follow-up care. This practice gives APNs the status of invisible provider and might restrict practices sites to just those linked with physicians (Poghosyan, 2018).
Apart from reimbursement barriers imposed by Medicaid and Medicare, several third-party payers, including managed care organizations and commercial insurers acknowledge APNs as qualified providers of healthcare, but variations in the coverage and reimbursement policies are extensive. As Joel (2017)indicate even in states that have given APNs full practice authority, numerous private and public payers hinder APNs from practicing autonomously from another health care provided by n reimbursing at a lesser rate or not making direct payments. This affects the ability of APN to practice independently and be able to bill for services.
Lack of uniform reimbursement by states has made APNs huge invisible and minimized the quality and quantity of care they presently offer. Also, reduced Medicare reimbursement for services provided by APNs makes financial solvency hard. Reimbursement barriers can be overcome by updating reimbursement policies for every payer to warrant that APNs are eligible to partake and are directly available to patients. As Joel (2017)claims, reimbursement should be a reflection of actual costs connected with the provision of quality care and advance the efficient and effective deployment of APNs as part of the healthcare provider workforce. Additionally, third-party payers must partake in directly reimbursing APNs who offer care within their authorized scope of practice.BARRIERS FOR ADVANCED PRACTICE NURSING.
Apart from reimbursement restrictions, states also impose further barriers for advanced practice nurses. Poghosyan (2018) assert that regardless of the standardization in advanced practice nurses’ educational preparation and training across the country, state scope of practice laws and regulations, which establish the breadth and type of services APNs can offer vary across states. Some states permit APNs to practice autonomously of physicians. Nevertheless, other states require them to have collaborative or supervisory relationships with physicians for them to provide care.
Although APNs are highly competent providers of healthcare, state scope the practice regulations impede APNs from offering care to the full level of their education and training and impede them from delivering healthcare to the millions of people requiring their care. As Joel (2017) recommends, utilization of APNs to the full level of their competence and knowledge can extend health care paradigm. APNs must be recognized as complete associates with physicians along with other health care professionals in the redesign of healthcare in the country to attain improved health outcomes.BARRIERS FOR ADVANCED PRACTICE NURSING.
Lack of uniformity in the role of the advanced practice nurse
Different states use different titles for APN, such as nurse practitioner, advanced nurse practitioner, registered nurse practitioner, clinical nurse practitioner, and advanced registered nurse practitioner. According to Joel (2017) title discrepancy by state causes uncertainty about the role f APN. In addition, the variations in the way certification agencies direct APNs to denote their credential augments the uncertainty. There isn’t a standardized model to regulate APNs across states. Even though the Consensus model is a crucial step toward the elimination of the lack of uniformity, every state autonomously establishes the lawful scope of practice of APN, the roles that are acknowledged, the entry criteria into advanced practice, as well as the acceptable certification exam for assessment of competency. These have produced a major obstacle to easily relocate from one state to another and have lessened access to healthcare for patients.
Lack of uniformity in the role of APN can be overcome by developing and implementing a model that will help in the clarification of the APN role and ensure that APNs receive enough training to enable them to deliver safe patient care. Additionally, standards should be established to reaffirm the qualifications of APNs to serve populations autonomously within a range of states and medical environments (Joel, 2017).BARRIERS FOR ADVANCED PRACTICE NURSING.