Five strategies to utilize, support and retain advanced practice providers

By Randena Hulstrand

It's no secret that healthcare organizations, now more than ever, need to understand workforce trends and predict future needs to compete with new market disruptors and changing patient expectations. By capitalizing on the growing advanced practice provider (APP) workforce — amidst a growing shortage of physicians — is a sure way forward. Vizient data shows an 8.6% increase in APP jobs (like advanced practice registered nurses and physician assistants) from 2021 to 2022, and another 8.4% increase from 2022 to 2023. The data also shows 68% of APPs are working in medical groups.

"Patients want quicker and easier access to healthcare," said Christen Hunt, associate vice president of workforce consulting at Vizient. "Organizations have to meet patients where they are, and APPs are a big part of the solution — but championing these professionals' success is key."

The recently released Vizient report, Shaping the future of healthcare: Advanced practice providers, workforce planning and digital innovation, shares data and insights from provider organizations about how the APP workforce is changing along with tangible ways leaders can support them. Here are highlights from the top five strategies:

1. Grow digital strategy and technologies. An integration of telemedicine, remote patient monitoring and process optimization not only addresses the challenges faced by healthcare organizations but also presents opportunities for APPs and other healthcare providers to deliver more efficient and personalized care, ultimately improving patient outcomes.

   "For example, using remote patient monitoring with at-home medical devices is changing the game in how providers can monitor heart rates and contractions in pregnant women, especially in the current shortage of women's health services," Hunt said. "And there's a huge opportunity for endocrine and cardiology care to monitor blood sugar and blood pressures at home in real time, which in turn allows providers to make necessary changes more quickly and improve patient outcomes."

   

2. Utilize onboarding programs. To accommodate the expected growth in APPs, organizations must go beyond addressing hiring practices and proactively design a clear and standardized approach for the integration and enculturation of APPs into the organization. By investing in robust onboarding initiatives, healthcare organizations can empower these professionals to effectively navigate their roles and responsibilities, leading to increased engagement, heightened productivity and, ultimately, improved patient care outcomes."

   More organizations have a formal onboarding process for APPs in the ambulatory care setting compared to the acute care setting, attributed to the historical presence of more APPs in the ambulatory care setting," Hunt said. "This has supported the rise in the autonomy of APPs in the ambulatory setting, with increased patient care responsibility and complexity. We are seeing the expansion of APPs in the acute care setting signaling the need for the same robust onboarding to support their success."

   

3. Improve financial performance. To maximize the financial value of APPs, it is crucial for them to bill for the services they provide. Additionally, it is important to establish compensation methodologies that align with those of physicians. This helps to eliminate competition and foster a collaborative team environment. By aligning incentives, clear guidelines and workflows for billing can be established, which in turn facilitate accurate documentation and billing practices.

   "While some organizations and providers are concerned about potential revenue losses that could result from APP reimbursement rates that are 85% of the Physician Fee Schedule, the lower cost structure associated with APP and team models have demonstrated a bigger return on investment when APPs bill under their own National Provider Identifier," Hunt said.

   

4. Increase access to care. APPs play a crucial role in improving patient access, productivity and revenue. Additionally, when providers practice as part of a true care team model — where all providers, including APPs, see a mix of new and established patients — it not only enhances wait times and access but also yields a significant return on investment.

   "Instead of blindly adding more resources to solve for access and workforce issues, leaders should optimize the resources they have and assess their skill level needs," Hunt said. "For example, what skill mix do I already have? What tasks are providers doing that can be reassigned to other resources? What opportunities do I have to utilize an APP versus a physician?"

   

5. Implement APP leadership. The growing emergence of chief advanced practice provider officers in healthcare organizations has brought positive changes as they work collaboratively with the chief nursing executive and chief medical officer, often reporting to the chief executive officer or directly to the board. These leaders help support APPs in practicing at the highest level of their education and training, which includes creating policies and rules that align with the scope of practice for APPs, as well as having a good understanding of state and federal regulations for their practice."

   Having an APP leader at the table who understands how these professionals can be optimized ensures they are working at top of license, as well as promoting their professional development," Hunt said. "And they're positioned to help educate other c-suite leaders about the value of APP full scope of practice — all that can tremendously impact an organization's bottom line."

   

Explore the recently published Vizient report Shaping the future of healthcare: Advanced practice providers, workforce planning and digital innovation to learn more about how the APP workforce is changing.