NR 510 Week 3 Case Study: Organizational Behavior and Business Influences and Advanced Practice Nursing
You are a family nurse practitioner (FNP)
... [Show More] employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees). The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could behelpful. Your contract is up for renewal in 3 months. You are highly … with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend.
Discussion Question:
What negotiation strategies should you use to propose a contract renewal? How does your role asa 1099 contractor benefit the practice over the W2 employees? What evidence will you present tothe practice to reinforce your value in the practice both in terms of revenue and patient satisfaction? Consider any additional services you may … willing to provide under your contract.Use logical reasoning, and provide evidence based rationales for your decisions.Keep in mind that your negotiation terms and conditions must … within the legal scope of practice for an ANP.
Answer
Dear Class and Dr,
As a 1099 independent contractor Family Nurse Practitioner (FNP) in the last two years in a busy primary care setting with a desire to maintain my current role, the strategy that I would use to begin the process of negotiation is to understand the difference between W2 employee versus independent contractor, and then bring it to the table for an effective and professional discussion. I would also include examples, and strengths I contributed to the facility in the last two years during the discussions with the providers group. In addition, it is also important during the renewal negotiation process to tackle the importance of revenue that I contributed to the facility.
Based on my personal experience, I learned that being a full time W2 employee I receive several benefits the FNP or independent contractor don’t have such as 401k (matched by employer), health insurance, malpractice insurance (covered by employer), paid time off (PTO). That is why the organization will benefit from independent contractor as they don’t have to provide benefits such as the benefits mentioned above that W2 employee must have during active employment within the facility.
The evidence that I will present to reinforce my value in the practice that relates to the patient satisfaction and revenue is my length of employment, positive patient relationships, as well as colleague’s positive relationship and number of patient’s referrals. As a devoted independent contractor, it is seen in my work ethic for the last two years which the organization benefited from. My professional relationship with my patient promotes positive patient health outcomes, therefore it helps improves patient satisfaction causes more referrals, leading to increases facility’s revenues. Although, my main proposal is to continue as a leader and one of the main revenue contributors to the organization by increasing my productivity. For example, instead of seeing 15 patient a day, I would increase the number of patients to 20 a day. I would also discuss the utilization of the fee-for-service practice. This practice provides reimburses to the organization based on specific services that the healthcare professional provides to the patient thus generating larger number of organizations revenue (Kwak, 2014). Another important factor for a successful contract renewal is to show that I am an asset in my current role because I can be the primary care provider and accommodate as many patients as I can especially when Doctors are busy (Aktan, 2015).
Another aspect in contract renewal is to keep in mind that in our health care industry today, Aktan (2015) stated that highest patient satisfaction largely contributes to the success of the organization. Therefore, I would present this as evidence of my devotion to my profession. I would collect all the positive patient satisfactions and referrals made by my patient to this organization and to me as their primary care provider. I would collect the data showing the revenues made by this organization while I was employed for the last two years and if possible, point out the individual contribution made by the independent contractor. I think that by analyzing the patient satisfaction score as well as the revenues will be helpful in the process of my contract renewal.
References
Aktan, N. (2015). Patient experiences in ambulatory care and physiologic and functional health care outcomes as they relate to physician and non-physician providers. Community Medicine & Public Health Care, 2(1), 1-3. doi:10.24966/cmph-1978/100002
Kwak, J.P. (2014). Employees versus independent contractors: Why states should not enact statutes that target the construction industry. Journal of Legislation, 39(2), 295-316. doi:10.1016.2015.11.026
Student Response
Hello Jenna,
Thank you for your response, I currently work at a rehab facility where patient satisfaction is paramount. At our facility, Increased patient satisfaction means providing high quality of safe patient care and their family. We use patient stay surveys the day before discharge and we collect them at discharge day. This way patient and family will be able to participate and give their true reflection of care that the staff and our facility provided to them. Then, every month in our meetings, our nurse manager will give us the whole month patient satisfaction including the percent of recommending our facility to others. So far, we are always at above 98% patient satisfaction score and at 97% recommendations score. I believe that this score shown to affect the number of patient admitted in our facility, since I started working in this facility (5 years ago) we are always close to a full house, we have patients that stated “ I choose to come here because my friend was here last year when she had a stroke and she recommended me this hospital because the staff are excellent”. At some point we had patient waitlist because we were full and couldn’t take another patient. I think that the reputation of providing high quality of patient care helps generates increase revenue. I am sure that patient satisfaction will be helpful in 1099 contract negotiation because it reflects the important value of the staff. As I have said high quality of care leads to high patient satisfaction score thus increasing recommendations generating more and more patient which means generating more revenues.
Regards,
Tuto
Instructor Response
Thursday Jul 25 at 7:58pm
Hi Tuto,
Coming in prepared for contract negotiation is paramount, as well as having your agenda on how to increase revenue will surely give the impression that you want to be part of the team rather than just a plain employee. Preparation is key when it comes to contract negotiation. Good post!
Hello Dr Regalado,
Thank you so much for your feedback. I agree that having the agenda ready prior contract negotiation will be helpful, I also believe that if you love and value your role within that particular facility, it will reflect on your work, patient satisfaction, and also colleagues’ relationships. I also believe that the contract renewal will come down to my good moral character as a person. Good moral character includes honesty, respectful, reliability, nonjudgmental and professionalism. I think that the aspect of good moral character that could help with the contract renewal would be the positive relationship among other staff. If I have the best relationship with my coworker as I have right now at my current job, they will more likely to rehire or keep me as their employee. According to Pouramini & Fayyazi (2015), positive employee relationships is one of the key elements of a successful organization. In addition, positive employee relationship creates positive work environment which increases productivity, loyalty, reduced to zero conflict, embraces equality and sets goals. Ultimately, increased in productivity among employee generates more revenues to the organization (Pouramini & Fayyazi, 2015).
Regards,
Tuto
Reference
Pouramini, Z., & Fayyazi, M. (2015). The relationship between positive organizational behavior with job satisfaction, organizational citizenship behavior, and employee engagement. International Business Research, 8(9), 1-15. doi:10.5539/ibr.v8n9p57 [Show Less]