According to the American Medical Association, nurse practitioners (NPs) that are delivering emergency care without the supervision of a physician at Veterans Health Administration (VHA or VA) facilities may lead to extended hospital stays while increasing preventable hospitalizations. This is highly alarming considering hospital stays in this 3-year study were increased by roughly 11% and raises the 30 day preventable hospitalizations by 20%. This can reflect two possibilities of having NPs solely care for the patient while being hospitalized. One, being nurse practitioners may have poorer decision making than a standard emergency physician, over who they choose to admit to the hospital resulting in denial of patients who should have been admitted. The second reason being the NPs have lower quality of care.
Overall, this study has shown nurse practitioners are increasing the cost of VA emergency departments by 7%, about 66 dollars per patient. Increasing the number of NPs just to decrease the wait time has raised total healthcare spending by 238 dollars per case, or 15%. That is not including the costs of nurse practitioner salaries. Nurse practitioners were more likely to order an X-ray or computerized tomography (CT) scan and to seek formal consults than emergency physicians. By assigning 25% of emergency cases to nurse practitioners, it will result in 74 million dollar net costs annually for the VHA.
Some Medicare Advantage Plans work with the VA to give you a cost-effective look at the private sector, or reduce the amount you pay for Medicare while receiving other perks. Contact us to discuss your options!