Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers’ assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles. Also, be sure you are italicizing titles of online sources.No more than 200 words maximum.

• In subsequent posts compare and contrast your findings with your fellow classmates.(initial post is in attachment)

Tonisha’ Response:

In 2018, Americans spent $3.65 trillion on health care (Sherman, 2019). Increases in the costs of healthcare are expected to continue as more Americans are living with chronic health conditions. Managing the care of complex patients with chronic health conditions can further strain the primary care system as a shortage of primary care providers attempt to meet the health care needs of several populations.

Nurse practitioners are cost effective to the health care system in many ways. Nurse practitioners are academically prepared with reported tuition costs of up to 25 percent less than physicians (American Association of Nurse Practitioners, 2013). Nurse practitioners are able to provide high quality patient care and yield similar if not more improved patient outcomes in comparison to physicians. In reviewing cost related outcomes such as length of stays, emergency room visits and hospitalizations, patient care provided by nurse practitioners were comparable to physicians (American Association of Nurse Practitioners, 2013). Comparable savings are also noted in the compensation nurse practitioners receive. Nurse practitioners are compensated about one-third to one-half the compensation of physicians (American Association of Nurse Practitioners, 2013). In these examples, nurse practitioners are shown to be cost effective health care providers in relation to educational costs, patient outcomes and salaries.

Within the state of Florida, one million people are unable to access basic health care (Florida Association of Nurse Practitioners, n.d.). Over the next 5-10 years, 3,000 to 5,000 primary care providers are needed to meet the needs of Florida’s population (Florida Association of Nurse Practitioners, n.d.). Nurse practitioners can assist in relieving the shortage of primary care providers; however, restrictions on practice prevent nurse practitioners from practicing to the full extent of education and training. There are about 18,000 nurse practitioners within the state (Florida Association of Nurse Practitioners, n.d.). Removing restrictions on nurse practitioners practice would assist in decreasing health care costs and increasing access to high quality health care. No additional funding would be utilized as nurse practitioners are already well educated and trained to provide high quality patient care. In addition, individuals within the state would have increased access to health care services.

American Association of Nurse Practitioners. (2013). Nurse Practitioner Cost Effectiveness. Retrieved from https://www.aanp.org/advocacy/advocacy-resource/position-statements/position-statements (Links to an external site.)

Florida Association of Nurse Practitioners. (n.d.). The Advanced Practice Nurse Solution. Retrieved from https://www.flanp.org/page/TheAPRNSolution (Links to an external site.)

Sherman, E. (2019). U.S. Healthcare Costs Skyrocketed to $3.65 Trillion in 2018. Retrieved from https://fortune.com/2019/02/21/us-health-care-costs-2/

Vivek’s Response:

The reasons for escalating costs in healthcare are numerous. Costs are directly related to the dynamic environment between patient, provider, insurance, pharma, and policy. Two ways Nurse Practitioners can help contain healthcare costs is through health promotion/disease prevention and filling in the gap of physician shortages in parts of the county. To begin, it is important to understand the business model. Patients are consumers within this system meaning the revenue seen by provider, insurance, and pharma comes directly from the patient. Private insurance companies strive for profit by collecting more in premium dollars than they spend on healthcare services for their members. Public insurance wants to spend as little as possible as well to cover a growing publically insured population. One method of this is by adjusting reimbursements provided to providers. As patients demand more acuity care, cost increase overall.

Going back to the health promotion/disease prevention method- higher acuity care costs more to consumers. For example, a large percentage of unnecessary ED visits or increased demand for pharmaceutical interventions substantially increases costs. Studies show that because patients may not value healthcare as a service in which they are willing to invest their own money upfront, they have little incentive to actively participate in reducing costs (Branning & Vater, 2016). This translates to a lack of prevention and health promotion by the patient. A lack of proactive and preventative health leads to chronic and acute health conditions which place a demand on the system thereby increasing costs. In addition, insurance companies negotiate with manufacturers for the best possible price and organize their formulary accordingly, making lower-cost drugs available to patients with a lower cost-sharing responsibility and charge a higher price for their drugs to account for payer coverage gaps (Branning & Vater, 2016). This leads to increased costs associated with medications. Studies show that NPs are rated better at patient education, answering queries, listening, and pain management than physicians (Woo, Lee & Tam, 2017). This helps in health promotion/disease prevention which in the long run can create a healthier consumer base. NJ is a reduced practice state that require physician collaboration. Health promotion/disease prevention is s something that can be impactful throughout the country, regardless of state.

Reference

Branning, G., & Vater, M. (2016). Healthcare Spending: Plenty of Blame to Go Around. American health & drug benefits, 9(8), 445–447.

Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health, 15(1), 63. doi:10.1186/s12960-017-0237-9