Nurse Practitioner Medical Management Model

The Centers for Medicare/Medicaid Services has implemented financial penalties for hospitals experiencing high volumes of avoidable readmissions for certain medical conditions. This significant change created a financial incentive for hospitals to collaborate with post-acute care/long term care facilities and providers to improve transitions of care and to reduce potentially avoidable hospital readmissions of their shared patients/residents. In today’s environment, a successful mid-level provider program strengthens the nursing home’s position as an attractive partner for hospitals and health systems.

Our client, an integrated care delivery system offering an array of skilled nursing facility, home health, hospice, assisted living, and rehabilitation services, sought to examine the feasibility of incorporating the role of nurse practitioners into its skilled nursing facilities, increasing onsite presence of providers to evaluate and treat their residents in a consistent, proactive, timely manner. The client engaged Louise Bryde and Bob Moore, principal and senior advisor respectively at Stroudwater, to help them make this initiative a reality.

Phase I of the Engagement

Stroudwater evaluated several nurse practitioner models and presented recommendations to client leadership for their consideration/adoption. Stroudwater subsequently researched and developed multiple deliverables related to the selected model, including:

  • High-level strategic and tactical nurse practitioner model implementation plan
  • Internal/external communications plan
  • Draft NP position description and NP-MD collaborative practice agreement

Phase II of the Engagement

Stroudwater provided comprehensive support to integrate the role of employed NPs into the client’s care delivery system at selected pilot sites. Key deliverables included:

  • Development of a core foundation of information and tools essential for them to implement the NP model pilot effectively.
  • Preparation of a comprehensive NP model implementation manual, including multiple tools and resources. The manual addressed all facets of the process to integrate the NP role more broadly into the client’s care delivery system, in preparation for future expansion and system-wide integration of the NP model.