Employing midlevel providers boosts practice revenue, extends patient care, report finds

The number of practices employing non-physician providers (NPPs) has increased in the past 15 years, and for many, it’s boosting the bottom line, according to a recent report from the Medical Group Management Association (MGMA).

The report, “NPP utilization in the future of U.S. healthcare,” referenced MGMA data from 2009 showing that 61% of better-performing practices employed NPPs, and that jumped to 68% in 2013. The organization credits the improvement to the larger patient volumes that practices with midlevel providers can handle and patients’ expanded access to care.

“The reason is clear: Practices with NPPs typically perform better financially, generating higher physician income,” the report says.

“While it’s encouraging to see that practices who invest in employing non-physician providers benefit financially from such arrangements, medical groups are driven by the desire to serve patients and improve their satisfaction with their experience,” said Susan L. Turney, MD, MS, FACP, FACMPE, MGMA president and chief executive officer, in a written statement. “Being successful in a value-based environment will require practices to innovate and staff their organizations thoughtfully to ensure patients have access to their providers and are satisfied with their experience.”    

The report also shows that practices that employ both physicians and NPPs generate more revenue than clinics where NPPs operate alone. Its analysis of data from retail clinics, where NPPs were the only practitioners, showed that although staff operating costs were lower, revenue also declined. The total medical revenue for retail clinics was $177,636 per NPP, compared with $491,896 per physician at primary care practices.

But for primary care practices looking to expand, hiring a NPP might be more cost-effective than hiring another full-time physician, the report finds. In 2012, the median compensation for a family medicine physician was $207,117, compared with $94,062 for a primary care nurse practitioner. 

The report concludes that the number of NPPs will likely continue to grow. A 2013 survey from HealthLeaders Media showed that 45% of healthcare leaders plan on improving access to NPPs, according to the report.