Provider Collaboration Agreements

There is a critical lack of behavioural health care providers. A sequential study of mixed methods combining interview data (n-94) from a qualitative study of PMH NPA practice and a subset of quantitative data (n-699) from a national NRNPA survey that examines the effects of state-mandated APRN/MD cooperation agreements. Background: Twenty states, including Florida, require nurses to maintain a Collaborative Practice Agreement (CPA) with a physician as part of the state`s professional license. Professional licensing can increase prices and restrict access to services. Details of the conditions and costs of participating in a CPA for suppliers are poorly understood. This study looked at three specific objectives: 1) to study the impact of cooperation agreements on the costs and delivery of health services and similar models of regulation of health professionals. 2) Describe the variation in collaborative services that physicians provide to nurses through cooperation agreements and explore the links between the employer of nurses and the health care professional shortage (HPSA) sector without medical conditions at the CPA in Florida. 3) Describe the different costs of collaborative practice agreements offered by physicians for nurses, and explore the links between the employer of nurses and HPSA with the nurse`s payment for the CPA in Florida. Methods: A multi-method study with the distribution of an electronic survey to practicing nurses in Florida with two stages of recruitment at the Florida Nurse Practitioner Network Annual Conference and by email using the publicly available license.

The analysis of the data included descriptor statistics, chi squares and qualitative descriptor methods. Results: CPA-like regulatory structures in different health disciplines increase the cost of health care and reduce the number of health care professionals providing health care. CPAs contain vague language, and 24% of nurses in Florida report that no conditions of physician collaboration are included in the agreement. Ten per cent of nursing doctors say they have to pay a doctor to participate in a CPA. Nurse practitioners of the independent employment and non-hospital practice were not accompanied by conditions of physician collaboration and payment to the physician for participation in the CPA. Collaborative practice agreements, with no conditions of collaboration with physicians, were linked to payment to a physician for the CPA. Connections with hpSA do not show significant results. Conclusion: This thesis has improved our understanding of the structure, conditions and costs of CPAs in Florida. The variability in the conditions and costs of CPAs does not promote a level playing field between nurses and physicians. In a 2011 commentary for the American College of Clinical Pharmacy (ACCP), health policy advisor and physician Terry McInnis stressed the need for pharmacist-physician collaboration to improve positive patient outcomes and reduce health costs.