Marketing, Contracting and Reimbursement for the Advanced

Practice Nurse

Charlene Baldwin, RN, BSN

Intro/overview

• Creating effective marketing strategies for seeking employment.

• Promoting and marketing the APN role to the public and potential employers.

• Analysis of contract considerations and negotiations.

• Analysis of reimbursement strategies for the APN.

Creating Effective Marketing Strategies

• Marketing Mix to Strategies is made up from 4 P’s Mix.

Image obtained from netmba.com

(Kotler, 2005)

The 4 C’s: A More Contemporary Approach

• The 4 C’s are a more customer oriented version of the 4 P’s.

Image obtained from sales-and-marketing-for-you.com

(Kotler, 2005)

Maslow’s Hierarchy of Needs

• This is one of the basis of understanding consumer’s motives for action

Maslow's_Hierarchy_of_Needs.svg  from Wikipedia Commons.

Psychographic Profile for the Public

• Needs=Access to Medical Professional. If not a Dr., then who?

• Wants=Competent diagnosis and plan of care.

• Fears=Doctors stretched thin now. What happens when HCR fully enacted?

• Desires=More “face time” with a designated Primary Health Care provider.

Psychographic Profile for Potential APN Employers

• Needs=Primary Health Care Provider to fill void by lack of Doctors.

• Wants=Competent diagnosis and plan of care for clients.

• Fears=APN represented as substitute for M.D.

• Desires=Ability to prescribe meds a plus.

Promoting and Marketing the APN

• Address Needs/Wants/Fears/Desires using 4C’s.

• Engage in active dialogues with both Public and Potential Employers

• When confronted with issues, work with concerned party to find mutually beneficial solution.

Public Campaign

• Engage Public through website/blog, educational and social networking sites. (Facebook, Twitter and Wikipedia.)

• Other avenues of communication: Public Access Cable, Public Appearances, Printed educational material, Talk radio, volunteer to be at anything needing expert medical advice.

Public Campaign (cont.)

• Give specific definitions of what an APN is and isn’t. (SOW=Scope of Work. Not an M.D. substitute. Ability to prescribe meds.)

• APN is still a Nurse. Patient advocate.

• Detail recovery rate benefits using an APN.

• APN position is essential in recovering from Health Care personnel crisis.

Potential Employer Campaign

• APN essential position with M.D. shortage. (Looming larger w/ HCR.)

• In AZ, APN can prescribe meds.

• APN is a position with accredited education and certification.

• Cost outlay is outweighed by lost revenues of patients unable to be seen otherwise.

Potential Employer Campaign (cont)

• SOW fits within most Hospitals/ Private Practice.

• Convenience=APN can reach affected populations without local health care facilities. (Benefit for Public as well.)

• Client value is close and APN can always reference M.D. when needed.

Potential Employer Campaign (cont)

• Potential employers can be referred to APN’s online resume, Linked-In acct or personal website/ blog.

• APNs can network with other Health Care professionals. Carry business cards with easy contact information.

Effective Marketing Strategies for Seeking Employment

• 4 P’s of marketing

• Marketing strategies

• Organizational considerations

• 4 P’s of employment

4 P’s of Marketing

• Product

• Price

• Place

• Promotion

(Purdue University, 2005)

Pur

Marketing Strategies

• Networking

• Volunteering

• Professional organizations

• Information interviews

• Internet

• News paper

(Careers and Employment, 2010)

Organizational Considerations

State regulations for APNOrganization’s• Mission• Structure• Strategic priorities• Culture

(Hamric, Spross, Hanson, 2009)

Organizational Considerations

• Nursing philosophy• Share of organizational power• Definition of APN roles• Knowledge of supporters and alliances for the

position• Commitment to interdisciplinary care and

continuous improvement principles

(Hamric, Spross, Hanson, 2009)

Organizational Considerations

• Communication and collaborative process among providers, administrators, and APNs

• Data that supports the position• Credentialing requirements• Financial objectives• Resources• Model of care delivery

(Hamric, Spross, Hanson, 2009)

4 P’s of employment• Preparation

• Practice

• Personal presentation

• Pertinent questions

(Careers and Employment, 2010)

The Very Fine Art of Negotiation

• Identify what is important to you

• Prioritize

• Ask for more than you expect

• Be prepared to lose some points

• Seek Win-Win

Beyond Salary and Health Benefits

• Role-associated costs

Continuing education fees

License renewal fees

National certification renewal fees

Malpractice insurance

Tail coverage insurance policy

Additional Contract Points to Consider

• Scheduled raises

• Pension plan opportunities

• Professional association membership fees

• Professional journal dues

• Cell phone and pager charges

• Internet access fees

• Online literature fees

• Restrictive covenants

• Termination clauses

• Termination without cause clause

• Include standard clause that defines contract modifications implementations

• Mutual termination clauses

• Consider legal review of contract

Contract Language: What does it Mean?

Salary Negotiations

• Options

Hourly rate paid as annual salary

Compensation based on productivity

Compensation based on payer mix• Discuss ANP benefits

For patients

Generating income

Salary Negotiations

• Newly graduated APNs should request fixed salary vs. productivity compensation

• Additional benefits to consider:

Bonuses

PTO

Disability and life insurance

Profit-sharing

Average FNP Salaries

• National Average $88,000

• Phoenix AZ $97,000

• Chicago, IL $98,500

• Houston, TX $99,000

• Baltimore MD $113,000

• Memphis, TN $75,000

• Charlotte, NC $82,000

Conclusions

• Marketing is involved, ongoing and evolving.• The same marketing channels can be used to

engage the public and employers. Strategies vary by psychographic profiles.

• Salary negotiations require you don’t sell yourself short. Consider all of the expenses involved in being a working APN.

• Carefully consider Contract Language and Compensation method.

Questions???

References

Careers and Employment (2010). Employment seeking strategies. Retrieved from www.careers.qut.edu.au/student/resource/

Employmentseeking.pdfHamric, A. B., Spross, J. A., & Hanson, C. M. (2009).

Advanced practice nursing: an integrative approach, (4th ed). Retrieved from University of Phoenix eBook collection

Hansen_Turton, T., Ritter, A., Rothman, N. & Valdez, R. (2006). Insurer policies create barriers to health

care access and consumer choice. Nursing Economics, 24(4), 204-211.

References

Kleinpell, Ruth & Perez, Diego. (2006). Negotiation strategies for ACNP practice. The Nurse Practitioner. 31(5).

Kotler, Phillip (2005) According to Kotler: The World’s Foremost Authority on Marketing Answers Your Questions. Pg 13. AMACOM Books, 1601 Broadway, NY, NY 10019. Purdue University (2005). Marketing’s Four P’s: First steps for new entrepreneurs. Retrieved from www.ces.purdue.edu/new