Managed Care Organizations

Managed Care Organizations

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Managed Care Organizations

The collaborating psychiatrist would not allow the NP to work with adolescents younger than 14 years old, and they had to be of adult height and weight. The clause in the education law states that if there is a disagreement between the NP and the physician, the physician’s preference takes precedence in spite of the NP’s educational level or years of experience (NPANyS, 2009a). Twenty years ago, statutory collaboration was developed as a political compromise. The statutory collaborative agreement serves no public purpose, nor is it a substitute for professional judgment. Healthcare professionals are responsible for knowing their respective scope of practice and safely practicing within that parameter. Professional judgment is a requirement of NP practice and an expectation of the public (NPANyS, 2009a).

Managed care organ iza t ions have dominated healthcare delivery over the past two decades. These companies have become multi-state corporations that establish their own set of rules. These rules exclude NPs as providers on the insurance company panels and impose addit ional practice restrictions, such as mandating a statutory collaboration agreement with an empanelled physician. In addition to insurance company restriction, organized medicine has launched an aggressive campaign to further restrict scope of practice of APRNs through federal

Journal of the New York State Nurses Association, Volunne 42, Numbers 1 & 2 11
Barriers to Practice and Impact on Care si;- [, ‘j”’ii-/¡ “,;,.

Psychiatric NPs are the logicai aiternafive to continue to aiiow open access { • to higii quaiity mentai tieaitti care.

and state legislation that would give physicians more power and control

over nursing practice (American Nurses Association, 2009).

There are few studies in the literature addressing the statutory collaboration, reimbursement, and access to treatment as barriers to treatment (Elsom et al., 2005; Feldman et al., 2003; Staten et al., 2005; Pearson, 2009; Weiland, 2008; Lugo et al., 2007). An extensive literature review by United Behavioral Healthcare, as cited in Feldman and colleagues (2003), was conducted from 1997 to 2001. This review accounted for identified barriers to providing treatment, such as prescriptive authority, including lack of interest in the addition of prescriptive authority, work-setting limitations, personal comfort with prescribing, ability to develop a collaboration agreement with a physician, fees, legislative and statutory obstacles, and obtaining a Drug Enforcement Agency number (Feldman et al., 2003).

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.