By Dana Jacoby

The role of Advanced Practice Providers (APPs) – a popular industry term for non-physician, direct care providers in the office setting – is central to our country’s drive to improve patient outcomes.

As the workforce comes under increasing strain, healthcare organizations are becoming aware of the need to develop more sophisticated APP professional advancement programs. Employers aspire to positive working environments for physician assistants (PAs), and improved collaboration among healthcare provider teams.

Today we’ll look at the rise and constantly changing role of the Advanced Practice Provider. In this blog, we study how and why healthcare providers must adapt APP workflows to more effectively address patient needs — while also optimizing the skills of each team member for enhanced productivity.

Workforce Model Transformation

Helping APPs to reach their potential is the key to reducing the cost of care, improving patient access, progressing quality outcomes, and boosting provider satisfaction. Respected healthcare organizations understand today’s need to rethink current workforce models relating to the selection of personnel and how care is delivered. The performance of APP workforces must be aligned with the organization’s strategic goals.

Mercer claims that over 900,000 registered nurses are likely to quit permanently by 2026, which could leave 29 states unable to cope with demand. Labor shortages threaten providers’ bottom line in the long term, as hospitals increase wages and other benefits to sweeten their workforce and square up to the competition from on-demand staffing agencies. Clearly it’s time to recognize the role of APPs as a career, not just a job.

To achieve the desired efficiencies, APPs must be rewarded for improvement efforts. Aside from offering more attractive compensation, providers are looking to promote interdisciplinary models of team based healthcare delivery. Hospitals have reported decent results after implementing professional advancement programs focused on specialization, continuous learning and quality improvement, and evidenced-based practice.

Meanwhile, leadership skills training is focused on the design of novel practice models.
Investors have injected millions into physician and nurse staffing startups over the last 18 months in response to the burnout crisis. However, the big changes cannot be addressed by apps or new software alone, as they involve a quickly widening scope of practice responsibilities for APPs. The very definition of the term and the work involved is set for a dramatic shakeup.

Expansion of Scope

For now, the degree of autonomy extended to APPs varies state by state.

Physician groups and medical associations tend to oppose APP scope of practice expansion, as they value the long-standing tradition and effectiveness of team-based healthcare provision. This entails one or more physicians directing a team of APPs and auxiliary staff. Opponents to scope expansion are concerned that it will result in a more siloed culture, weakening accountability and collaboration.

However, all the signs are that the industry is heading on a slow but steady course toward expanded scope of practice for APPs. This trend was put into action when the scope was widened on a temporary basis in reaction to the COVID-19 pandemic, as part of the urgent all-hands-on-deck approach to tackling the coronavirus.

For example, Massachusetts Governor Charlie Baker signed a wide-ranging healthcare bill to permanently codify the expanded scope of practice permitted during the pandemic. The changes mostly relate to the work of Nurse Practitioners (NPs), Optometrists, Nurse Anesthetists and Psychiatric Nurse Mental Health Specialists.

Arkansas Governor, Asa Hutchinson, introduced legislation in March last year to permanently codify his earlier executive order, which granted full independent practice authority to Nurse Practitioners and Certified Nurse Midwives. His new legislation also changed the practice relationship between Anesthesiologists and Nurse Anesthetists. What used to be a supervisory role is now ‘collaborative.’

Plugging Physician Shortage Gaps

The scope of practice for pharmacists was enhanced during the pandemic due to the urgency in rolling out COVID-19 vaccines on an accelerated schedule. Virginia now permits pharmacists to independently prescribe and administer vaccines.

Several other factors are working to push the necessity of scope expansion. One is the opioid crisis, which has powered the trend toward independent practice, as the demand for addiction treatment far outweighs today’s volume of available physicians. The crisis provoked the Comprehensive Addiction and Recovery Act, which widens the prescriptive authority of Nurse Practitioners under federal law with regard to drugs like Suboxone.

Another factor is the growth of rural elderly and near-elderly populations across the US, which is intensifying demand for primary care services. Several state legislatures are addressing the care gap by permitting independent practice for certain APPs.

Nearly every state legislature debated scope of practice bills in 2021. An incredible 280 bills were introduced last year to adjust the status of various APPs. However, the success of these bills was inconsistent; some were struck down.

What’s clear is that NPs and PAs already have a strong track record of plugging physician shortage gaps. A 2019 report printed in Annals of Family Medicine showed an increase in appointment availability, mostly down to the extra capacity provided by NPs and PAs. They helped to prevent system bottlenecks when more patients secured health payer coverage due to the passing of the Affordable Care Act.
The Role of APP Consultancies

A dedicated APP solutions partner, in the form of a specialist like Vector Medical Group, can give organizations much-needed access to the knowledge, insights and tools needed to enact change and improve clinician performance. Vector Medical is led by experienced consultants who bring a wealth of clinical and healthcare operational expertise.

Our sophisticated, integrated workforce solutions, which span executive, physician, and employee compensation and performance strategies, are reinforced by our industry-leading productivity and compensation data, providing a strong foundation stone for our clients — and helping them realize their strategic goals quickly and effectively.

Vector Medical Group helps you to attract, engage and retain high-performing APPs in today’s increasingly competitive environment.
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