Nurse Practitioner: A Case Study

A nurse practitioner (NPs) have the option to negotiate their own contract and be compensate for what they believe they are worth. They are in high demand especially in the minute clinics, such as CVS, Wal-Mart health, and Walgreen (Annual Income for Nurse Practitioners on the Rise, 2015). The nurse practitioners salaries are determined by the going rate for a precise service in the geographic area and which also include their experience (Danielsen, Potenza, & Onieal, 2016). According to the American Association of Nurse Practitioner, the rate for NPs has increased from 98,786 in 2011 to 108,643 in 2015 (Annual Income for Nurse Practitioners on the Rise, 2015).

The courts distinguish between an employee, defined in s.248(1) of the Income Tax Act, hereafter, ITA, as the “position of an individual in the service of some other person”. An independent contractor, is someone with a “contract for service.” The case that considered an employee versus and independent contractor was Wiebe Door Service Ltd. v M.N.R. In this case, the applicant owned a door instalment business and had a number of contractors that worked for them. The contractors were responsible for their own taxes, workers compensation and unemployment insurance. However

Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)

Reimbursement for the advanced practice nurse (APN) is improving but how they fit into reimbursement systems is vey important. One question that arises is if the APN should be paid the same fee for service as a physician or should only a percentage of the payment be received. Most third-party reimburses, which include a few large insurance companies are now reimbursing APNs and more states are getting on board with reimbursements by developing reimbursement models for APNs (Hamric, 2009). For example, Aetna US Healthcare, Anthem Blue Cross and Blue Shield of Kentucky, Medicare and Medicate all credential NPs as primary care providers and pay at 85% of the physician rate. Tricare of Kentucky credentials NPs and pays 100%.

For my Clinical experience, I was referred to one of community clinics run by nurse practitioners - yes, NPs- in Suffolk County in Long Island by my coworker. It is called “Nightingale Preventative Care.” I am working in the ER and at first, I thought this clinic would be a type of urgent care office which is a similar setting to the ER. I was totally wrong. For the past two weeks, this place has surprised me many ways and I learned about what the community clinic is alike to its neighbors. Patients can be seen by NPs by the appointment. However, it is located inside of K-mart and has many walk-in patients as well. Many patients who come to visit for their check-up have no medical insurance. Every Wednesday, a representative from Fidelis Care insurance company comes and provides information about Medicaid and Medicare service the company has. I really like to sit down with patients and assess about their medical histories and family histories which I cannot do often in the ER. I had a patient who was Hepatitis A Ab, Total positive Abnormal first day I work at the clinic. He didn’t understand what the test result meant and neither did I. I printed out an article from National Library of Medicine and went over with him. Patient’s education in the ER rarely happens from nurses. I felt great to listen what patients tried to lose their weight or quit smoking. I like to continue on developing skills on patient’s education and preventative care measure for patients.

Retrospectively reviewing this legislation, it is unknown as to why nurse practitioners were not granted 100% reimbursement or why the nursing profession accepted this payment scale. Every government policy is implemented within a historical perspective. Fluctuations in the environment and economic constraints have an immense effect on the ability of legislation to pass the many obstacles of government (3). In 1997 the government was undergoing vast budget cuts due to a declining economy. Although the American Nurses Association, state nurse practice organizations and nurse lobbyists originally argued for 97% of the physician reimbursement, however due to the current budget cuts the assumption that a lesser percentage would be more successful

With advances in medicine, Americans are living longer and with chronic illnesses that require long term medical maintenance. As the population has grown with patients that are aging and becoming sicker in the process, there has presented a shortage of physicians to manage this rise in demand. Now, with the passage of new legislation such as the Affordable Care Act, more patients have access to health care than ever before. Many experts have suggested increasing the utilization of Nurse Practitioners and Physicians assistants as a cost effective resource to tackle to rising cost of healthcare amid a physician shortage in America. Several studies have been performed to assess the viability of these options, to address the advantages and

The Texas Workforce Commission uses a 20 point comparative approach to define employment status with one sentence describing an employee and one for describing an independent contractor under each category. One of the main differences between the two are a person is an employee if the

The face of healthcare has been changing over the last decade. The role of nurse practitioners has become ever more important. This paper conducts a policy analysis as a systematic investigation of alternative policy options, for the emerging nationalized healthcare plan and the increased use of nurse practitioners. It looks at the goals of nationalized healthcare 's use of nurse practitioners and discusses to what extent this policy meets these goals. This paper begins with a detailing of the problem addressed by the policy and the goals and objectives of nationalized healthcare 's increased use of nurse practitioners. Next, alternatives to meeting the increased needs of the health industry,

There are also benefits for employees as well, such as, avoiding long-term absences which result in the employee having a difficult time returning to the workforce; maintaining a stable income, job skills, and self-esteem. (Management of Occupational Health and Safety, 2011, 327)

IRS (2011) Employee vs. Independent Contractor – Seven Tips for Business Owners. http://www.irs.gov/newsroom/article/0,,id=173423,00.html Last accessed January 3, 2012.

When choosing whether to classify a worker as an independent contractor or an employee the employer has many tax related and non-tax motivations to choose the former. The biggest motivations are the many taxes that the employer will not be responsible for withholding if they choose to classify a worker as an independent contractor. One of the largest responsibilities of an employer is the role it plays as tax collector for the government. If an employer is able to classify its worker as an independent contractor rather than an employee they would not have to worry about withholding federal income tax, FICA taxes, FUTA taxes, and state income taxes. Instead this burden would fall

The factors I had to consider were convenience/flexibility, overall estimated pay per hour, wear-and-tear on my vehicle, how the hours format might affect my ability to work another job, and whether or not the new expected pay was worth my overall involvement (as a contractor without benefits).

Employee benefits are a tool used by businesses to attract potential applicants, improve employee satisfaction, reduce turnover and maintain competition. Benefits that most employers offer include, but are not limited to, medical and dental coverage, time away from work, retirement, and additional assistance during life changing events. The majority of employers in the United States offer benefits to their employees and include an annual enrollment yearly to select benefits and make any needed changes.

Approximately 16% of the employment growth in 2012-2022 is really good and approximately 57% of general contractors are self-employed. Being self-employed is probably much better and with a general contractor degree, you’ll be able to make a lot more money than working for a construction company. For me I wouldn’t mind for working with a construction company at first. Once I know I can manage to handle to own my own company I will, I know it’ll be stressful but I’ll get more money being self-employed. I know how stressing it would be because my dad has his own company of landscaping