Measuring Nurse Practitioner Productivity

Abstract and Introduction

As the role of the nurse practitioner (NP) evolves, the need to demonstrate productivity becomes more important. Productivity data provides NPs with practice statistics to generate business or use in contract negotiations with potential clients such as employers, managed care organizations, and insurance companies. However, beyond the numbers of patients seen per day or amount of reimbursement a provider brings to the practice, NPs may provide additional benefit that is not captured with physician productivity measures. Information to acquaint NPs with key aspects of recording productivity and ways NPs can organize productivity data within their practice to determine worth of service are presented.

Over the years the nurse practitioner (NP) role has evolved into an impressive dimension focused on providing quality care to the community served. This focus includes the tasks of teacher, researcher, consultant, mentor and coach, leader, and ethical decision maker. It involves practice in a variety of acute and chronic care sites such as hospitals, clinics, and private offices. The care the NP provides includes information on health maintenance and disease prevention, counseling, and patient education.

As the role of the NP evolves, the need to demonstrate productivity also becomes more important. Twenty years ago research measurement focused on public safety and quality of care. Today measurement of productivity is important in determining the worth or value of NP practice. Further, productivity measures are used to monitor individual performance, create incentive plans, compare departmental contributions within institutions, and monitor resources needed for patient care (Johnson & Newton, 2002). Industries outside of health care have long recognized the vital importance of productivity measurement on its enterprise. They believe that enhanced productivity improves the business enterprise's opportunity to create wealth for its workforce (Proctor, 2005). But very little information has been published related to ways NPs can measure productivity and efficiency.

Cite this: Measuring Nurse Practitioner Productivity - Medscape - Feb 01, 2006.

Condensed Version of NONPF Competencies
Health promotion and protection Disease prevention Teaching and coaching Critical thinking Role model and advancement of the role Improving health outcomes Works collaboratively with team Monitors and ensures quality care Culturally competent Interpersonal communication skills Assessment of all aspects of patient's health status Diagnoses of health states Plans care Implements care safely and efficiently Evaluates care Serves as a consultant

Source: NONPF, 2005

CPT Codes and MD Time
CPT CODE Description Office Visit	Physician Supervision Required	Total RVU
Outpatient: CPT Code 99211	Physician need not be present (only supervising)	0.00
Established Outpatient: CPT Code 99212	Physician Time: 10 minutes	0.06
Established Outpatient: CPT Code 99213	Physician Time: 15 minutes	1.41
Established Outpatient: CPT Code 99214	Physician Time: 25 minutes	2.21
Established Outpatient: CPT Code 99215	Physician Time: 40 minutes	>5

RVU Comparison
CPT Codes	RVUw (w = physician work)	RVUpe (pe = practice expense)	RVUm (m = malpractice risk)	Total RVU
99212- No physician needed to do skill	0.45	0.59	0.02	0.06
99213- Low	0.67	0.72	0.02	1.41
99214-Moderate	1.00	1.07	0.04	2.21

Critical Questions to Ask
Who are our customers? Are they satisfied? Do they stay? Do they keep their appointments? Are they compliant? Are the financial returns adequate cost versus benefit? Is there growth in our customer base? Are we providing services and products in a productive way to our customers? Are we operating efficiently? Are we competent? Are we friendly? Are we available to customers when they need us?

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Measuring Nurse Practitioner Productivity

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