N516

Advanced Practice Nursing Role: Financial Management Issues

Spring 2002

FIRST CLASS MEETS Jan 23

Credits: 1, (7, 2 hour seminars)
Class Hours: Weds 12-1:50 every other week 

Class dates: Jan 23, Feb 6, Feb 20, Mar 6, Mar 20, Apr 3, Apr 17

Office Hours: by appt.
Classroom: 4 Dieffendorf
Recommended Prerequisite: N511

Faculty:
Dr. Carol Brewer
Stockton Kimball Tower, Room 912 (Office)
Office: 829-3241
Secretary: Marianne Messina, 829-2342

Communications:
Email: 
csbrewer@acsu.buffalo.edu
Listserv address: 
n516-list@listserv.buffalo.edu

DescriptionObjectivesRequirementsGrading | AssignmentsScheduleReadingsLinks | Additional Resources|

Course description
This course is designed to introduce the APN to concepts relevant to managing the clinical and fiscal outcomes of their practice. An organizing framework of entrepreneurship is used. Reimbursement mechanisms and the implications for practice in various settings, basic budgeting concepts used to manage a practice and standardized decision making methods used to evaluate the cost effectiveness of clinical outcomes will be discussed. Evidenced based practice and the implications for cost and quality will be discussed. 

Objectives:

  1. Describe Medicare, capitation and other reimbursement issues as it applies to a practice and the ethical implications of each.
  2. Develop a budget and manage resources, including knowing when to seek the services of external resources such as a lawyer or practice consultant.
  3. Demonstrate fiscal accountability for one’s own practice while providing quality care.
  4. Monitor the effectiveness of cost effectiveness of clinical decisions and make recommendations for increasing the cost effectiveness of care.
  5. Identify and utilize appropriate information systems needed to manage a practice.
  6. Identify ethical issues in practice management.
  7. Examine the issues of productivity and human resource development in providing care, and the implications for quality outcomes.
  8. Consider issues relevant to designing a culturally relevant and competent practice. .
UB Statement of Principle on Academic Integrity 

The University has a responsibility to promote academic honesty and integrity and to develop procedures to deal effectively with instances of academic dishonesty. Students are responsible for the honest completion and representation of their work, for the appropriate citation of sources, and for respect for other’s academic endeavors. By placing their name on academic work, students certify the originality of all work not otherwise identified by appropriate acknowledgements. 

NOTICE FROM THE OFFICE OF DISABILITY SERVICES:

"If you have a disability (physical, learning, or psychological) which may make it difficult for you to carry out the course work as outlined, and/or, requires accommodations such as recruiting note takers, readers, or extended time on exams and assignments, please contact the Office of Disability Services(ODS), 25 Capen Hall, 645-2608, and also the faculty during the first two weeks of class. ODS will provide you with information and review appropriate arrangements for reasonable accommodations." 

Requirements:
This course is structured in a workshop format. There will be some lecture, discussions and in-class exercises as well as guest presentations and a final student presentation. Each student is expected to complete required readings prior to class and to participate actively in class discussions. Attendance is required. 

Skills: basic understanding of the internet, email, spreadsheets and word processing is expected.
Basic knowledge of a spreadsheet is essential today. If you do not know Excel, I strongly encourage you to take one of the CIT courses available.

Required texts:

1. Delio, SA, (1999): The Perfect Practice for an Efficient Physician.Englewood CO: Medical group Management Association

and

2a. Go to http://www.planware.org/busplan.htm.Download the Free-Plan (another version on the internet is Biz-Plan).There are many other resources available on the internet. 

OR

2b. Mannino, MJ. (1994). The Business of Anesthesia: Practice Options for Nurse Anesthetists. Park Ridge, IL: American Association of Nurse Anesthetists Publishing. 

And required for all students (except highly recommend for Anesthesia students)

3. Buppert, C. (2000). The primary care providers guide to compensation and quality: how to get paid and not get sued. Gaithersberg MD: Aspen Publishers, Inc.

Highly recommended:

Bolles, R.N., (2002). What color is your parachute? Ten Speed Press: Berkley, CA, ch 12.

On reserve:

Bolles, R.N., (2002). What color is your parachute? Ten Speed Press: Berkley, CA, ch 12.

Buppert, C. (1999). Reimbursement for nurse practitioner services. Nurse Practitioner Business Practice Legal Guide.  Gaithersberg, MD: Aspen, Inc. 

Buppert, C. (2000). The primary care providers guide to compensation and quality: how to get paid and not get sued. Gaithersberg MD: Aspen Publishers, Inc.

Calmelat, A. (1991) Tips for starting your own nurse practitioner practice. Nurse Practitioner 18, 4, 58-68 

Mazzocco, W.J., (2000) Nurse practitioners and incident to billing: the indirect billing method. Medscape Nursing 1-7

Zaumeyer, C., Zukowski, L. (1995). The nurse practitioner as entrepreneur: How to establish and operate an independent practice. Fort Lauderdale, FL: Women’s Health Watch. 

Grading:

Part A50%

Part B50%

After 2 days, late plans will be penalized 5%.
 Grade guidelines:

A = 94-100
A- = 90-93
B+ = 87-89
B = 83-86
B- = 80-82
C+ = 77-79
C = 73-76
D = 70-72
F = below 70 

Assignments:

There is no existing text book that meets the needs of this course exactly.Therefore, I have assigned certain resources and indicated the availability of many more.Some texts are highly recommended for your permanent library, such as Buppert's two books, but only a few chapters are pertinent to this course. Other chapters may be pertinent to the other two role courses.

When the readings refer to the business or company, substitute in your mind your practice and/or professional career.How can you use these techniques of analysis to "grow" yourself?

You have two assignments for this class both of which are related to writing a business plan.However, in this case, the focus is YOU; your planned practice as well as your professional career.We are going to focus on you as the center of the business and development process.This business plan is an allegory for the process in which successful career people engage.It means determining where you are going, how you are going to get there, and what the outcomes of the process will be.The parts of the business/career plan you will be expected to turn in are in two parts.The first part (Part A) will be a solo assignment, and second (Part B) can be accomplished with NO MORE than 2 people.

If you are not in a clinical assignment, you may find interviews with a business manager or a nurse practitioner in a practice similar to one you would prefer very useful for some parts of the assignments.

Part A: 50%

1.20% Practice Overview (This is the equivalent of the market analysis; address each of the points below). No more than 3-4 pages. Should be short, clear and concise, outline form acceptable where appropriate and understandable. 

Describe the practice in which you wish to pursue a career.

a.Business Environment and Market definition: If you do not already know what type of practice in which you wish to practice, then for the purposes of this assignment you must choose one.

a.Describe a practice location, community characteristics, practice size, patient characteristics (age, sex, socioeconomic status, insurance status, ethnicity, geographic location or other pertinent characteristics). 

b.What is the legal form of this practice and why was it selected; are there any advantages/disadvantages for you personally?

b.Buyer behavior /Customer profile: Describe the physicians and other personnel with whom you expect to work. Describe your expected role in this practice and the patient load you expect to carry.What kind of patients do you expect to see, if different from or a subgroup of, the general practice? What are the most common patient problems you expect to see?How will you address cultural issues relevant to your practice?

c.SWOT analysis: What are your strengths (Why should someone hire YOU?) and weaknesses (internal/personal/professional) that will affect your practice/patients and relationships with your coworkers? Opportunities and threats (external to you, for ex: great mentor available but poor job security)? 

Against this backdrop you will write the next section.If you do not know, you will need to select a potential area of practice and develop the rest of this plan as if it is fact.

2.5% Write a mission for your practice and a vision for your career. (1/2 to 1 page)

3.10% Mission, goals and objectives.1-2 pages

a.What do you have to offer any potential employer? And how will you continue to develop your expertise, professional skills, and reputation (eg minimize weaknesses)? How and when will you do this?

i.Include at least three 1 year goals, two 3 year goals, and one 5 year goal, with at least three objectives for each goal. 

1.Note: Goals and objectives should deal with developing your practice and professional career, not your personal life. 

2.Note: language varies here: strategies and goals are general statements that address the SWOT analysis, objectives (but sometimes called goals!) are the specific measurable statements.

4.10% Quality assessment plan (not part of the usual business plan).1-2 pages

a.This section should explain how you will monitor the quality of at least ONE specific service (see Buppert). What will you monitor, how, and what outcomes are expected?

5.5% References/grammar. Document any resources used, including people, using APA format. Online, text and other resources should be listed using APA documentation, and appropriate references used in the text.

Part B:Salary Proposal (based on revenue generation) (50%). (3-5 pages)

Partner with someone in a very similar situation to you.

Using the 20 most common CPT codes and reimbursements for visits or procedures that you will use, write a salary proposal estimating the revenue you will bring to the practice within the first year.Describe the process you used to estimate the revenue and simplifying assumptions you made to estimate it.Include realistic estimates of productive time, keeping in mind that you do not see patients all the time (eg you need time for charting, lunch and vacations/sick days etc), and that it will take you some time to become efficient.

Include a copy from Part A of the practice description on which the following is based.

1.(5%). Your specific CPT/Procedure code list with estimated reimbursements. Explain estimated prevalence of the CPT codes, and source of reimbursement information.

2.(15%) Show, preferably on a spreadsheet, how you estimated your revenue generation for the practice you are in.This should be estimated for the first year of practice and include all non-productive time. Eg don't assume you will immediately be fully booked! And you need lunch, sick days and vacations..

3.(10%) Present range of salaries researched on internet or other sources (updated for inflation if necessary), and how/why they do or do not apply to your situation(s). 

  1. (15%). Present brief persuasive argument for a salary based on the above data (include if necessary, persuasive arguments (what is the value you add to the practice so they should pay you this amount?) based on information from first part of plans. Assume your share of overhead is 35%, unless you can document otherwise and include it here. Also consider any payments you must make to collaborating physicians, if necessary. 
  2. (5%) References: Document any resources used, including people, using APA format. Online, text and other resources should be listed using APA documentation, and appropriate references used in the text. 
  3. One page summary (required for last class, not graded).
Use of spread sheet highly recommended, as once you enter basic data and formulas, you can play as nauseum with assumptions and obtain different scenarios easily.

Course Schedule

 
Date
Topic/Speaker
Assignments due in class
Jan 23  Topic I   Entre/ intra-preneurship 
Definitions and discussion of the business plan as a career guide. 
Mission, goals, objectives. 

Legal and financial considerations: permits and licensure 

Many resources are available online and in the library. You are responsible for identifying adequate resources to develop your plan. 

Read all documents from Free Plan

http://www.planware.org/busplan.htm

Mannino: Ch 1, 2, 4, 7

Feb 6 Topic 2 

Guest Speaker: Leo Blatz, MS, RN, 
Past Owner, Travel Nurse

Contract and salary negotiation

Mannino Ch 6

Buppert (1999) ch 10, The Employed Nurse Practitioner, p273-304

Bolles ch 12-The Seven Secrets of Salary Negotiation

Feb 20  Topic 3:  Estimating salary and revenue.

Mannino Ch -3 

Buppert (2000) PCP Guide Ch 9, 10, 11, 13

Mar 6 Topic 4: Charging for your services 

Guest Speaker: Donna Keith McKain, RN NP Homelink Medical Services

Payment for services and billing, income estimation

Medicare 
Private payers 
Capitation 
Barriers and constraints in reimbursement for ANPs

By now you should have the CPT code information you need.If necessary, you should interview an ANP in the desired type ofpractice to obtain this information. Bring to class information about the reimbursement available for your services from Medicare (check HCFA internet sites) or other insurance. 

http://www.medscape.com/medscape/Nurses/journal/2000/v02.n02/mns0320.mazz/mns0320.mazz.html

http://www.medscape.com/medscape/Nurses/AskExperts/2001/12/NP-ae89.html

http://www.medscape.com/CBuppert/GreenSheet/2001/v03.n08/green0308.html

Mar 20 Topic 5: Practice management 

Information systems, productivity, cultural and ethical issues (no pay patients), cost effectiveness

Guest speaker: Jennifer DiFlavio, MBA. Manager MF Gates Ambulatory Care Clinics

Delio: The Perfect Practice ch 1-15

Part A due

Apr 3 Topic 6 Quality management 

Buppert (2000) PCP Guide. Skim/review ch 1-8

Determine the quality targets you intend to meet for your practice. Identify the processes and outcomes you want to monitor. Determine how you will collect and monitor the data 

Apr 17  Topic 7  Group presentations of salary proposals. Part B due

Prepare a one page summary of your salary proposal to distribute to class.

Links:

Shareware

http://www.planware.org/busplan.htm

http://www.planware.org/papers.htm

http://www.planware.org/online.htm

http://www.bplans.com/

http://www.business.com/directory/healthcare

http://www.sba.gov

http://www.businessweek.com/smallbiz/index.html

http://www.Practicesupport.com

http://geography.about.com/education/geography/msub55.htm

http://allnurses.com/jump.cgi?ID=78

http://www.nursefriendly.com/nursing/directory/ny.html

http://www.lopez1.com/lopez/business.htm

http://www.lopez1.com/lopez/business.htm

http://www.monsterhealthcare.com

Salary websites from Money September 2000p113, roughly in order of value:

Http://www.salary.com

www.acinet.org

www.bls.gov/ocohome.htm

www.erieri.com/doltrends

www.futurestep.com

www.jobstar.org

www.wageweb.com

www.careerjournal.com

www.compgeo.net

Optional readings and resources 

There are two copies of BIZPLAN Builder on computers in the lab. The paper text is only available with this more expensive version of the software. The paper text is available from Ms Dickey to check out from the lab. 

For free shareware try http://www.bplans.com

Business Basics software can be bought and downloaded directly to your computer from the http://www.JIAN.com web site. An optional, more complete software version is: 

JIAN Tools for Sales (2000). BizPlan Builder Interactive Vs 7.0. Mountain View, CA:Thompson Executive Press. 

Tiffany, P & Peterson, S.D., (1997). Business Plans for Dummies. IDG Books Worldwide: Foster City, California

Baxter, E. (1993). Head nurse’s perceptions of their roles. Part 1-2. Canadian Journal of Nursing Administration. 6 (3), 7-16. 

Blouin A.S., & Brent, N.J.,(1995). Legal insights: the nurse entrepreneur. Legal aspects of owning a business. JONA 25, (6), 13-4. 

Crofts, A.J. (1994). Entrepreneurship: the realities of today. Journal of Nurse Midwifery. 39 (1), 39-42. 

Curran, C.R., (1995). An interview with Sandra C. Matherly and Shannon Hodges.
Nursing Economics 13 (3), 125-128. 

Haag, A.B., (1997) Writing a successful business plan. AAOHN Journal, 45 (1), 25-34. 

Kaplan, SM. (1991). The absolutely basic concepts of being a nurse entrepreneur. Pediatric Nursing. 17 (2), 179-182. 

Orga, J., (1996). Becoming a nurse entrepreneur. Tennessee Nurse, 59 (2), 13-4. 

Pinardo M., and Newell, M. (1997). Reinventing your nursing career. Aspen Publishers 

Vogel, G. & Doleysh, N. (1994). Entrepreneuring: A nurse’s guide to starting a business" (2nd Ed). New York, NY: NLN Press. 

Woerner, L. (1994). Business risk and the health care entrepreneur. Holistic Nursing Practice. 8 (2), 22-7. 

Books:

Arkbauer, JB (1995). The McGraw Hill Guide to Writing a High-Impact Business Plan; A Proven Blueprint for Entrepreneurs. New York: McGraw Hill 

Gumpert, D E (1996). How to Really Create a Successful Business Plan. Boston, MA: Inc Publishers 

Harper, S.C., (1991). The McGraw Hill Guide to Starting your own Business: a Step by Step Blueprint for the First Time Entrepreneur. McGraw-Hill: New York

JIAN Tools for Sales (1997). BizPlan Builder. Mountain View, CA:Thompson Executive Press. 

Pinson, L. Anatomy of a Business Plan: A Step by Step Guide to Starting Smart… (1996) 3rd edition. Chicago: Upstart Publishers 

Purdy, W. (1996). The Service Business Planning Guide: The Complete Handbook for Creating the Winning Business Plan….Boston MA: Inc. Business Resources