Independent APRN Reimbursement in Minnesota: An Evaluation of APRN Understanding

Abstract

Purpose: Measurement of knowledge through the question “How well do advanced practice registered nurses in Minnesota understand current reimbursement practices?” Background Independent advanced practice registered nurses are reimbursed 65-85% compared to 100% reimbursement for physician peers under the current payer system. Reimbursement inequities limit the services that are offered to patients, negatively affecting patient care across all settings. Evaluation of knowledge of reimbursement practices are needed to determine legislative next steps for full practice progression. Methods A Doctoral Nursing Practice project measuring understanding of current reimbursement practices in Minnesota through Qualtrics post-then-pre survey, providing education on current reimbursement practices. The survey was electronically posted to social media and sent via email listserv. Post-then-pre survey metric included one demographic question, and five questions on reimbursement practices. The intervention was measured and data compiled by Qualtrics through the University of Arizona. Results There were 152 respondents with 80 comprehensive participants. The data showed small variation with data clustered around the mean. There were statistically significant changes from the pre-then-post responses showing the educational program was successful. Program pre-then-post scores changed by -100% at the lowest metric, and +233% improvement at the highest metric showing statistically significant results. The largest change after intervention was the question “I had/have a clear understanding of the use of incident to billing and Medicare fraud when criteria are not met.” The question regarding “I recognized/recognize limited APRN reimbursement in Minnesota as a barrier to practice in Minnesota” offers suggestion for full support of equality of reimbursement as participants recognized limited reimbursements as a barrier to practice. Conclusions Main themes identified in the survey results include APRN improved knowledge of reimbursements and recognition of current reimbursements for APRNs as a barrier to practice. The objectives measuring APRN knowledge of reimbursement practices in Minnesota were completed. The data was collected and documented APRN reimbursement knowledge on indirect billing. The data surrounding APRN knowledge was completed and evaluated to determine that adoption of the reimbursement changes are needed in the state of Minnesota. Full practice authority includes practice equality as well as reimbursement equality.