An Innovative Role for Nurse Practitioners in Managing Chronic Disease

Denise Boville, MSN, CRNP; Mandeep Saran, MSN, CRNP; James K. Salem, MD, FACE; Lynn Clough, MA; Ronald R. Jones, MD

Disclosures

Nurs Econ. 2007;25(6):359-364. 

In This Article

Evolving Role of Nurse Practitioners

Nurse practitioners (NPs) can play a valuable role in a redesigned process for chronic illness care due to their ability to address the multidimensional nature of chronic problems (Fiandt, 2007). Successful interventions focused on chronic diseases include complex actions that address psychosocial and lifestyle issues, as well as physical problems (Fireman, Bartlett, & Selby, 2004). Additionally, payment policies and state nurse practice acts that previously constrained the roles of NPs have changed to enable a higher level of practice reimbursement for services (Mundinger et al., 2005). Nurse practitioners in all states have authority to prescribe medications, allowing them to provide services to chronically ill patients, such as adding and intensifying medications. With establishment of algorithm models of care, NPs can execute recommended care plans autonomously within care settings. Nurse practitioner visits may qualify for direct reimbursement from Medicaid, Medicare, and commercial insurance, supporting the addition of NPs to a practice setting. Additionally, the wages, benefits, and overhead associated with employing NPs tend to be more cost effective for some patient populations than employing physicians to provide that care. The role of the NP in chronic illness care provides a wider clinical context for developing a caring relationship with patients, and offers autonomy to the NP, although still working within collaborative relationships with physicians.

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