Transcript Slide 1

2014 MAPRA Conference
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
Advanced Practice Provider (APP) Trends
for Hospital and Clinic-based Practices
Presented by: Josh Schneider
Managing Director
AdvancedPractice.com
Presented to:
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
Learning Objectives
• To learn basic information about the recruitment of APP’s
(Advanced Practice Providers), specifically Nurse Practitioners
and Physician Assistants
• To learn information about APP practice settings and the
areas that APP’s specialize in
• To learn APP nationwide trends related to employment, practice
and growth areas
• To review the results of the most recent AdvancedPractice.com
Compensation and Employment Survey and the Jackson
Healthcare Advanced Practice Trends Report
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
The learning objectives for this session are:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Over 192,000 NP’s practicing in the US
Estimated 14,000 new NP’s completed their academic programs in 2011-2012
95% have graduate degrees
97% maintain National Certification
18% practice in rural or frontier settings
88% are prepared in primary care and 76% of all NP’s practice in primary care
85% see patients covered by Medicare and 84% by Medicaid
43% of NP’s hold hospital privileges and 15% have long term care privileges
97.2% of NP’s prescribe medications averaging 20 scripts per day
NP’s hold prescriptive privilege in all 50 states with controlled substances in 49
2011 mean full-time NP base salary was $ 91,310 with average of $ 98,760
2012 average annual compensation was $ 99,836
60% of NP’s see 3-4 patients/hour, 7% see over 5 patients/hour
Average NP is female (96%) and 48 years old and has been in practice for 12.8
years as a family NP (49%)
**AANP, revised 2013 and AP.com 2013 Compensation/Employment Survey
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
Nurse Practitioners by the Numbers
Distribution, Mean Years of Practice - NPs
Percent of NP’s
Years of Practice
Acute Care
6.3
7.7
Adult (pcare focus)
18.9
11.6
Family (pcare focus)
48.9
12.8
Geriatrics (pcare focus)
3.2
11.6
Neonatal
2.1
12.3
Oncology
1.0
7.7
Pediatric (pcare focus)
8.3
12.4
Psych / Mental Health
3.2
9.1
Women’s Health
8.1
15.5
Exclusively dedicated to Advanced Practice Providers
Locum tenens
2014 MAPRA Conference
Population
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
•
•
•
•
•
•
There are an estimated 93,000 certified PA’s practicing in the US
PA’s can practice in all 50 states
All 50 states have enacted laws that authorize PA prescribing
2 states – FL and KY do not allow PA’s to prescribe controlled
substances
In 2013, the full-time annual salary average was $ 107,268
($ 51.41/hour average).
Average PA salary increase from 2012 to 2013 was $ 5,103
which was a smaller increase than that of
NP’s that increased by $ 5,785
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
PA Snapshot
Growth in Utilization of APPs Nationwide
In a report released in 2010, The Robert Wood Johnson Foundation found that
between 1995 and 2009, the number of NP’s per primary care physician had
more than doubled (0.23 to 0.48). As did the number of PA’s per primary care
physician (0.12 to 0.28)
This data shows that the combined NP-PA workforce is already three quarters the
size of the primary care physician workforce. It is likely to continue as the
number of PA’s (93,00) is more than double its size of 10 years ago and the NP
profession has grown to over 192,000.
A 2011 National Center for Health Statistics report showed that the percentage of
hospital outpatient visits handled by NP’s and PA’s rose from 10% in 2000 to 15% in
2008. The Bureau of Labor Statistics predicts a 23% increase in Nursing jobs
and a 41% increase in PA jobs from 2008 to 2018.
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
US New’s report on healthcare jobs in 2014, stated that Nurse Practitioners were the
#2 job listing and Physician Assistants were the #8 job listing
Forces at work propelling demand
* The U.S. healthcare system is undergoing an epic
* The Baby Boom generation has begun its consumption of greater
amounts of medical care
* A shortage of primary care physicians looms
* Chronic diseases are increasing
* The complexity of care proliferates
NP’s and PA’s are positioned to be a critically important player
in responding to these converging trends.
**2012-2013 Jackson Healthcare Advanced Practice Trends Report
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
transformation, opening what’s predicted to be a flood of
additional medical consumers
At a Glance
Over 1,000 respondents
• 73% Nurse Practitioners
• 22% Physician Assistants
• 5% Other APP’s
• 83% are female, 17% are male
• 83% full-time, 17% part-time (Part-time
increased over 2011)
• 65% have been in practice for 9 years or
less
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
Employment Status
• 70% are Employees (91% salaried, 9% hourly)
• 14% are Locum Tenens or Independent
Contractors exclusively
• 4% are solo practice, owner or partner
• 2% are PRN
• 1% are Retired
• 9% Other
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
(continued)
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
Practice Settings
• 51% are employed at a practice/clinic or officebased setting (up 4 percentage points from 2011)
• 20% are employed in hospitals
• 8% in Government (VA, IHS, Military, Corrections)
• 3% in Outpatient Surgery or Urgent Care Center
• 3% in Nursing Home, Assisted Living, Long Term
Care facility
• 2% in Mental Health facility
• 2% in Academic settings
• 1% in Home Health
• 10% Other
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
(continued)
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
Who Owns the Facility in which they work?
• 41% - A hospital or health system
• 26% - A Doctor or Group of Doctors
• 25% - A Company or Corporation
• 4% - A Nurse Practitioner or Group of NP’s
• 4% - Don’t Know
Where Did They Find Their Current Position?
• 36% - Referral , word of mouth
• 34% - Internet
• 10% - Professional Association
• 13% - Staffing or Recruiting Agency
• 7% - Other
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
(continued)
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
(continued)
83% - Yes
17% - No
Top 4 Reasons to leave current practice setting in the next 6
months:
#1 – Lifestyle Choice, seeking less time working and more
time in private life
#2 – Seeking more challenging work / patient variety
#3 - Seeking more leadership opportunities
#4 – Money / Compensation package
• Money dropped from #1 in 2011 to #4 in this year’s survey
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
Do they anticipate remaining in this type of practice in the
next 6 months?
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
Nurse Practitioner Job Satisfaction with current practice
• 28% Very Satisfied
• 46% Satisfied
• 23% Dissatisfied
• 3% Very Dissatisfied
Top 5 Reasons for Nurse Practitioner Job Satisfaction:
#1 – Patient Care / Type of Work Performed
#2 – Work Environment / Setting / Relationship with
Colleagues
#3 – Compensation and Benefits
#4 – Autonomy
#5 – Variety / Challenging Cases / Ability to Grow
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
(continued)
Results of the AdvancedPractice.com
2012-2013 Compensation and Employment Survey
PA Job Satisfaction with current practice
• 33% Very Satisfied (slightly more than NP’s)
• 38% Satisfied (8 percentage points below NP’s)
• 20% Dissatisfied
• 9% Very Dissatisfied (6 percentage points higher
than NP’s)
Top 3 Reasons for PA Job Satisfaction:
#1 – Work Environment / Setting / Relationship with
Colleagues
#2 – Patient Care / Type of Work Performed
#3 – Compensation and Benefits
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
(continued)
Results of the Jackson Healthcare Advanced
Practice Trends 2013-2013
#1 – Supervisor / Management – 27%
#2 – Don’t Feel Valued – 22%
#3 – Salary – 19%
#4 – Support Staff – 13%
#5 – Physician Attitude
The Top 3 Qualities that NP’s and PA’s seek in a work
Assignment
#1 – Work / Life Balance – 59%
#2 – Pay – 57%
#3 – Control over schedule – 34%
• Other factors include friendliness, location, independence,
training and working in a team environment
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
The Top 5 Drivers of NP / PA Dissatisfaction
A study by Moran and Hooker documents the movement of PA’s from primary
care to surgical and medical subspecialties from 1997 – 2006. The PA workforce
doubled during this time. However, the IM subspecialty PA workforce increased
262% and the surgical subspecialty PA workforce increased 186%.
*Major types of NP’s:
1. Family Nurse Practitioner – 31% of total practicing
2. Adult Nurse Practitioners – 18% of total practicing
3. Pediatric Nurse Practitioners – 18% of total practicing
4. Other NP Specialties – Women’s Health, Psychiatric/Mental Health,
Occ. Med, Geriatric, Correctional Health – 33% of total practicing
*Most in demand in our practice at AP.com:
1. Psychiatric / Mental Health with Family Psych certification
2. Cardiovascular / Cardiothoracic Surgery PA
3. Primary Care NP – FNP, ANP, etc.
4. Occupational Medicine NP
5. Orthopedic Surgery PA
6. Correctional Medicine PA or NP
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
Specialties in Highest Demand
Key Questions APPs Want Answered
in a Job Interview
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
What is the patient population in the practice? Adult, Geriatric, Pediatric?
What is the specialty of the practice? Primary Care, Psych, Surgery, Emerg Med?
Is the practice focused on a particular patient base? Disabled, Women, Fertility?
What is the APP’s role in the practice? First assist, clinic work, psych evals?
What is the work schedule? Weekdays, weekends, on-call?
Are there other APP’s in the practice? What is their role?
Is there a supervising / collaborating physician in place? How broad or
limiting is the collaborative agreement?
How much responsibility and autonomy will I be given?
How many patients will the APP be expected to see per day?
Does the practice use EMR? Will there be training on the EMR system?
Why is the position open? Is it a replacement or an expansion?
Will the APP need to be credentialed / privileged by the hospital?
What is the salary and benefit package – include paid CME and license cost ?
Will there be an employment contract?
What are the growth opportunities in this role?
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
• Medical / Surgical Services delivered by PA’s and NP’s are covered by
Medicare, Medicaid and nearly all private payers.
• Medicare pays for medical and surgical services provided by PA’s and NP’s at
85% of the physician fee schedule. This applies to ALL practice settings
including hospitals, nursing homes, clinics, first assist in surgery for PA’s, etc.
• “Incident To” billing is a Medicare provision that allows for services provided by
a PA or an NP in a physician’s office to be billed under the NPI of the physician
with reimbursement at 100%. This billing requires the claim to be billed with the
“Q6” modifier.
• Shared Visit Billing is a Medicare provision that allows for services provided in
the hospital by both the APP and the physician to be billed under the NPI of the
physician with reimbursement at 100%.
• APP’s must apply first for their own NPI number and then enroll in Medicare via
the PECOS system. Many private insurance payers are now reimbursing for
APP services direct and not through “Incident to” or “Shared Visit” billing.
• Overall, APP’s can provide 80-85% of the services that a physician can
provide at 1/3 to 1/2 the cost.
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
PA/NP Reimbursement
Helpful Links
*American Academy of Nurse Practitioners (AANP) – www.aanp.org
*Champion Nursing – www.championnursing.org
*Advanced Practice.com 2012-2013 Compensation and
Employment Survey – www.advancedpractice.com
*Jackson Healthcare Advanced Practice Trends 2012-2013 – An
attitude and outlook report on Nurse Practitioners and Physician
Assistants – www.advancedpractice.com
*Advance for NP’s & PA’s – www.advanceweb.com/NPPA
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
•American Academy of Physician Assistants (AAPA) – www.aapa.org
A distinctive difference:
The only national, full-service Locum Tenens agency
dedicated exclusively to Advanced Practice Professionals
Niche, full-service job board
Employer postings at no charge
Audience-specific positions
Strategic marketing partnerships designed to extend market reach –
making for more cost-effective recruiting than our clients can do on their
own
Our Value to our Clients
We:
• Are Industry experts
• Have the highest quality providers
• Have client-specific service delivered in concierge style
• Offer automated service delivery
• Are “high touch” with our clients and providers
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
2014 MAPRA Conference
AdvancedPractice.com
2014 MAPRA Conference
Questions?
Exclusively dedicated to Advanced Practice Providers
Locum tenens
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009
Thank you!
Exclusively dedicated to Advanced Practice Providers
Locum tenens
2014 MAPRA Conference
Josh Schneider
Managing Director
AdvancedPractice.com
[email protected]
678.690.8204 Direct
404.964-7321 Cell
404.751.5215 Fax
Contract to hire
© Copyright 2012. AdvancedPractice.com I 877.740.0404 I 2655 Northwinds Pkwy. Alpharetta, GA 30009