Financial viability, benefits and challenges of employing a nurse practitioner in general practice
Christopher Helms A B , Jo Crookes A and David Bailey AA National Health Co-op, 20 Cartwright Street, Charnwood, ACT 2615, Australia. Email: medicaldirector@nhc.coop; ceo@nhc.coop
B Corresponding author. Email: chelms@nhc.coop
Australian Health Review 39(2) 205-210 https://doi.org/10.1071/AH13231
Submitted: 4 December 2013 Accepted: 29 October 2014 Published: 22 December 2014
Journal Compilation © AHHA 2015
Abstract
This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment.
What is known about the topic? NPs represent a growing workforce of highly trained and educated advanced practice nurses that aims to improve access to timely and affordable healthcare for underserviced populations. Recent legislation has allowed for greater exploration of innovative models of care using NPs in Australian primary healthcare.
What does this paper add? This case study provides practical information on the financial and logistical implications of employing an NP in a bulk-billing general practice. It demonstrates the broad capability of this workforce in Australian primary healthcare, and gives an overview of the facilitators and barriers to their use in private practice.
What are the implications for practitioners? Employment of a PHC NP in general practice requires careful consideration of the direct and indirect benefits associated with the complimentary care they offer. NP access to the Medicare Benefits Schedule is severely restricted, which impairs their ability to achieve a full scope of practice and may contribute to increased health system costs and inefficiencies. There are opportunities for integration and facilitation of this emerging role in general practice with existing nursing workforce. Further research into this evolving area would be of benefit.
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