Private Practice CRNP owned NURS 7226 Beth Anne

Private Practice CRNP owned NURS 7226 Beth Anne Kelley Lindsey Saunders Lauren Studdard

History • NP Role: Rooted in primary care and patient-centered • The 1960’s • President Kennedy’s assassination, President Johnson’s “War on Poverty”, and the women’s movement • The 1970’s • Rapid influx of Health Maintenance Organizations (HMOs) • Emphasized primary care and lower hospitalization rates • First Primary Care NP Role: care of children • Other roles have emerged over 4 decades • Families, Adults, Older Adults, and Women • Variety of practice settings • Private Practice • More broad-based venues for practice

Requirements • Licensure -active unencumbered Alabama RN license • Education -Masters or higher degree in advanced practice nursing from an accredited program • Certification -certified by a boardrecognized certifying body

NP-Physician Collaboration • CRNP is the BOSS • The collaborating physician must be readily available when needed • The same 10% requirement is mandatory for NPs who own their own business • 10% of NP scheduled hours • 10% of MD chart review • Team Approach • • Restrictions on NP Practice Effective collaboration = Comprehensive, patient-focused care Professional Ethic Complex needs of primary care

More on collaboration • Collaborative model should include: • Stress shared goals • Responsibility • Accountability • Practice philosophy • Independent and cooperative decision-making • Allow for differences in opinions and approaches • Security of one’s own unique professional identity • Approval for referral

Prescriptive Privileges • Approved formulary for legend drugs of any classification • Standard family is non-controlled legend drugs • Controlled substances or restricted classes are on the specialty formulary (prescribed by physicians or NPs who have a DEA license)

Preparing for this role • Licensing, Tax, and Insurance Regulations • • • State Nursing License Advanced Practice License and Certification Collaboration Agreement State and Federal Narcotics License Medicaid and Medicare Provider Number and Managed Care License National Provider Number (NPI) Clinical Laboratory License Employee ID Number (tax ID number) Professional Liability and Malpractice Insurance Conventional Commercial Insurance

Preparing for this role • • • Develop a Business Strategy, Plan and Time-line Determine Business Structure Business Name and Location Financing Fees, Reimbursements and Billing Hire Staff and Management Personnel Purchase Equipment Develop Human Resource Management Strategy Quality Assurance Policies and Procedures Marketing Strategies

Salary • Mean Income of Nurse Practitioners in 2013 • United States: $95, 070 • Alabama: $88, 320 • Montgomery, Al: $90, 070 • Income of NPs who own the practice is dependent upon number of patients, type of practice and services available. • Practice growth and expansion of services will increase revenue.

QUESTIONS/COMMENTS

References Alabama Board of Nursing. (2003). Advanced practice requirements. Retrieved from http: //www. abn. alabama. gov/Content. aspx? id=623 Alabama Board of Nursing. (2003). Alabama administrative code. Retrieved from http: //www. abn. alabama. gov/Content. aspx? id=123 American Nurses Association. (2013). Frequently asked questions about prescribing controlled substances. Retrieved from http: //www. nursingworld. org/documentvault/aprnresource-section/faq-about-prescribing-controlled-substances. pdf Bush, N. , & Watters, T. (2001). The emerging role of the oncology nurse practitioner: A collaborative model within the private practice setting. Oncology Nursing Forum, 28(9), 1425 -1431. Retrieved from http: //eds. a. ebscohost. com. spot. lib. auburn. edu/ehost/detail? sid=f 3 faa 200 -7 b 2 c-412 f-b 35 aabe 217 e 317 f 6%40 sessionmgr 4005&vi d=6&hid=4203&bdata=Jn. Npd. GU 9 ZWhvc 3 Qtb. Gl 2 ZQ%3 d%3 d#db=aph&AN=952 2538 Hamric, A. B. , Hanson, C. M. , Tracy, M. F. , & O’Grady, E. T. (2014). Advance practice nursing: An integrative approach (5 th ed. ). St. Louis: Elsevier. Barberio, J, (2010, July). Establishing an independent nurse practitioner practice. Advanced Healthcare Network for NPs & Pas. Retrieved from http: //nurse-practitioners- -and-physicianassistants. advanceweb. com /features/ articles/establishing-an-independent-nursepractitioner-practice. aspx United States Department of Labor, Bureau of Labor Statistics (2013). Occupational employment and wages: Nurse practitioners (Publication No. 29 -1171). Retrieved from http: //www. bls. gov/oes/current/oes 291171. htm