Accountable care drives demand for NPs, PAs, -AND- Report: Health System Quality Varies Among Calif. Communities

CAL/AAEM News Service - BP calaaem.news.service at gmail.com
Fri Mar 16 09:40:56 PDT 2012


 

Description: Description: Description: Description: Description: CAL/AAEM:
California Chapter of the American Academy of Emergency Medicine

March 14, 2012

 

Accountable care drives demand for NPs, PAs

 

Fierce PracticeManagement
<http://www.fiercepracticemanagement.com/press_releases/survey-reveals-physi
cian-shortage-challenges-medical-groups-and-increases-d?utm_medium=nl&utm_so
urce=internal> 

 

 

With physician shortages widespread and pressure to create teams to deliver
more accountable care, demand for nurse practitioners and physician
assistants is growing rapidly. According to the American Medical Group
Association's (AMGA) and Cejka Search 2011 Physician Retention Survey, 67
percent of medical groups that responded said that involvement of advanced
practitioners in their offices has grown "somewhat" or "significantly" in
the past five years, with 75 percent expected to hire more NPs and PAs
within the next five years.

 

During the past year alone, new positions for PAs and NPs grew 21 percent
and 13 percent, respectively. According to an article from U.S. News and
World Report, economics are a big contributor to the boon, as NPs fulfill
many primary care needs for about half of the cost of an internist at an
average salary of $99,000 per year.

 

Advocate Health Care, a multi-hospital system in Oak Brook, Ill., for
example, told U.S. News that it recently hired more than 60 care
managers--many of them nurse practitioners--and was poised to hire 60 more
NPs in the coming year. Some of the hires will be to replace doctors who
leave the organization.

 

Such high demand puts NPs and PAs in the driver's seat when it comes to
choosing where to work, and it shows. According to the AMGA/Cejka survey,
the turnover rate for advanced practitioners last year was a staggering 12.6
percent, nearly double the combined, adjusted physician turnover rate of 6
percent.

 

"Recruiting and retaining physicians and advanced practitioners is more
critical now than ever," Lori Schutte, president of Cejka Search, said in a
statement obtained by FiercePracticeManagement. "But finding, hiring and
keeping them is a growing challenge."

 

 

 

March 14, 2012

 

Report: Health System Quality Varies Among Calif. Communities

 

California Healthline
<http://www.californiahealthline.org/articles/2012/3/14/report-health-system
-quality-varies-among-calif-communities.aspx#ixzz1p78gXK6R> 

 

 

Health care access, quality and costs vary among California communities,
according to a national report by the Commonwealth Fund, the Los Angeles
Times reports. 

 

The study found that, overall, higher income areas in the U.S. were more
likely to have better health system performance than lower income areas
(Terhune, Los Angeles Times, 3/14).

 

Methodology

 

For the report, researchers ranked 306 hospital referral regions across the
country based on 43 health-related indicators, such as 30-day heart attack
mortality rates and the percentage of uninsured adults (McKinney, Modern
Healthcare, 3/14). 

 

Researchers used data mostly from 2008 to 2010 (Los Angeles Times, 3/14).

 

This is the first Commonwealth Fund report to focus on local health systems.


 

National Rankings

 

The highest-ranking communities in the U.S. for health system performance
included:

St. Paul, Minn.; 

Dubuque, Iowa; and 

Appleton, Wis. 

 

Some of the lowest-ranking regions in the U.S. were Shreveport, La. and
Jackson, Miss. (Modern Healthcare, 3/14). 

 

California Rankings

 

Out of the 306 U.S. communities studied:

Santa Rosa ranked 6th; 

San Mateo County ranked 9th; 

San Francisco ranked 50th; 

Ventura ranked 93rd; 

Orange County ranked 142nd; 

San Diego ranked 150th; 

Palm Springs/Rancho Mirage ranked 187th; 

San Bernardino ranked 220th; 

Los Angeles ranked 225th; and 

Bakersfield ranked 234th.

 

According to the Times, Los Angeles ranked lower because its rate of
uninsured residents -- 31% -- is higher than average and because it has a
shortage of basic preventive care services available. However, the area
ranked among the highest communities in the U.S. for avoiding unnecessary
emergency department visits among Medicare beneficiaries (Los Angeles Times,
3/14).

 

Santa Cruz County also ranked among the highest communities in the U.S. for
reducing dependence on ED services among Medicare beneficiaries (Gumz, Santa
Cruz Sentinel, 3/14).

 

In addition, Los Angeles, Orange County and Ventura had below-average costs
for patients with private insurance, according to the report (Los Angeles
Times, 3/14).

 

Implications

 

Karen Davis, president of the Commonwealth Fund, said, "This report shows
where you live in the country largely determines, better or worse, the kind
of health care you will receive."

 

Cathy Schoen -- coauthor of the report and a senior vice president at the
Commonwealth Fund -- said, "Local communities with higher rates of poverty
over 20% tend to lag behind more affluent communities, particularly for
access and preventative treatments."

 

Davis said that she hopes legislators and health industry leaders will
assess the practices of the high-ranking communities and use them to improve
patient care and curb increasing health costs (Los Angeles Times, 3/14).

 

The authors of the report said Medicare would "save billions of dollars on
preventable hospitalizations and readmissions" if all the communities that
were studied performed as well as the highest ranking communities (Modern
Healthcare, 3/14).

 

 

 

 

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service



 

 

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