Numbers Show Huge Nurse Practitioner Impact on Home Health

Non-physician practitioners (NPPs) play a huge role in providing Medicare home health services, according to recently released survey results from the National Association for Home Care & Hospice (NAHC). The results support the passage of the Home Health Care Planning Improvement Act of 2015 (S. 578/H.R. 1342), which would enable non-physician practitioners (NPPs) to certify Medicare home health plans of care, NAHC said.

NAHC conducted the nationwide survey amongst Medicare home health service providers on the use of and effect of NPPs, which include nurse practitioners, physician assistants, clinical nurse specialists and nurse midwives. The organization received 669 responses in total.

The findings show that reliance on NPPs as primary practitioners is increasing among Medicare beneficiaries across the United States. Specifically, 55.65% of responders said that 41-100% of their patients depend on an NPP as their primary or significant “medical” practitioner, as opposed to a physician.


The high percentage of patients depending on NPPs as their primary practitioners indicates the need to enact the Home Health Care Planning Improvement Act of 2015 to change Medicare’s outdated policy, NAHC said on its website.

According to NAHC, the findings also show that NPPs gaining the authority to certify Medicare home health plans of care would not raise costs, because it would lead to NPPs substituting for physicians, not increasing utilization.

Almost 40% of survey respondents said 91-100% of NPPs currently have a relationship with a physician who is willing and available to certify Medicare home health services. According to NAHC, this high percentage of NPPs with a close working relationship with a physician signals that NPPs would easily substitute for physicians as the primary practitioner without boosting Medicare spending on home health services.

Source: NAHC
Source: NAHC

Additionally, survey respondents predicted several positive outcomes as a result of the legislation to permit NPPs to certify Medicare home health services. For instance, 88.94% of respondents predicted reduced delays in care and access; 85.93% predicted improved patient care; 65.33% predicted lower care costs; and 51.42% predicted less paperwork.

Written by Mary Kate Nelson

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