Nurse Practitioners in Physician Practices: Implications for Member Satisfaction

Guerard B,Omachonu V,Rahurkar S

doi:10.4172/2471-9781.100006

Abstract

Background: There is limited information about how Nurse Practitioners can affect patient satisfaction among elderly patients. This study considered the implications of assigning in-office Medicare Advantage (MA) plan Nurse Practitioners (NPs) in Primary Care Physician (PCP) practices which were affiliated with the (MA) plan. Specifically, this was a baseline study that explored whether the presence of an NP in the PCP practice was associated with improved satisfaction of members of the MA plan with their PCP, and whether member satisfaction with their PCP was associated with satisfaction with the MA plan. Methods: Self-reported, cross-sectional data previously collected by the MA organization from enrollees was linked to data on participating PCPs. Twentytwo percent of responding members had a PCP with an NP in the practice. Multivariate logistic regression models were estimated to find the association between presence of in-office NPs and a ‘high’ member rating of the PCP, and the association between ‘high’ rating of PCP and ‘high’ rating of MA plan. Findings: PCPs with in-office NPs were four percentage-points more likely to be rated highly by members (OR: 1.37, p<0.05, 95% CI: 1.06-1.78) than those without NPs. Members who rated PCPs highly were also 24 percentage-points more likely to give the MA plan a high rating (OR: 6.58, p<0.01, 95% CI: 5.64-7.35) than members who did not. Conclusion: These associative relationships support an intervention where the MA plan has started placing NPs in PCP practices. Follow-up analyses will help ascertain whether embedding NPs had a causal impact on improving patient satisfaction. Keywords: Nurse practitioners; Medicare advantage; Patient satisfaction; Star ratings

Highlights

Since the 1970s, Medicare beneficiaries have had the choice of receiving Medicare benefits through private managed care plans, as an alternative to the federally administered traditional Medicare program
Our findings indicate that members who give a high rating to their Primary Care Physician (PCP) are more likely to give a high rating to the Medicare Advantage (MA) plan
We found statistical evidence that the presence of an Nurse Practitioners (NPs) in the practice was associated with higher patient satisfaction with the PCP, even after controlling for other important patient and provider characteristics-including controls for whether the patient felt that the PCP explained things well, listened attentively, and was always respectful

Summary

Introduction

Since the 1970s, Medicare beneficiaries have had the choice of receiving Medicare benefits through private managed care plans, as an alternative to the federally administered traditional Medicare program. This is sometimes referred to as ‘Medicare Part C’. This study considered the implications of assigning in-office Medicare Advantage (MA) plan Nurse Practitioners (NPs) in Primary Care Physician (PCP) practices which were affiliated with the (MA) plan. This was a baseline study that explored whether the presence of an NP in the PCP practice was associated with improved satisfaction of members of the MA plan with their PCP, and whether member satisfaction with their PCP was associated with satisfaction with the MA plan

Methods

Discussion

Conclusion