March 29, 2013 at 3:37 PM
Nurse practitioners sometimes replace doctors
Nurse practitioners receive unequal reimbursement
In regard to the column titled “You don’t always need a doctor” [Opinion, March 26] by Froma Harrop:
I am an nurse practitioner who works in a small private practice in Seattle and agree that with the shortage of family practice providers around, a great alternative is to see an NP.
The problem with this, though, is the fact that many insurance companies have begun decreasing the reimbursement rates for these “midlevel” providers. In the case of Premera’s switch as of March 1, it will only pay out 85 percent of what it would pay an MD for the same work and coding that an NP might see in a non-hospital setting. (They will reimburse 100 percent if that NP works in a hospital.)
So even though it is becoming more commonplace in our medical community to see an NP instead of an MD, we are not reimbursed equally for the same work.
Now that Premera has done this, it is only a matter of time before all insurance companies jump on board, which may eventually force NPs out of private clinics and into hospital-based settings. This could then cause a shortage of all primary-care providers in small clinical settings, making all patients see a general practitioner only in a hospital.
–April Rodriguez, Seattle
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