Community Healthcare Network, Inc.

Primary care physician shortage is a major issue and is predicted to worsen, but there are cost-effective solutions that do not sacrifice quality of care to mitigate this problem. For instance, nurse practitioner (NP) visits cost less than physician visits, and the outcomes of NP-provided care are equivalent to those of a physician.

However, NPs face barriers in practicing to the full extent of their scope of practice, which in turn may lead to their high turnover rate at medical facilities, especially in federally qualified health centers (FQHCs) that provide care for the medically underserved. To address this issue, Community Healthcare Network (CHN) developed the New York State Community Health Workforce Initiative (CHWI) model, which helps NPs perform to their fullest scope of practice. In 2016, NYHealth awarded CHN a grant to help health care organizations across the State use its model to improve the work environment for and maximize the use of NPs in primary care and behavioral health settings.

Under this grant, CHN implemented the CHWI model and provided clinical assessment, on-site analysis, and consultation services to participating health care agencies, including FQHCs and hospitals. Specifically, CHN conducted an NP-specific needs assessment of and a cost-benefit analysis for each agency and provided individualized recommendations. In addition, CHN provided implementation support, performed on-site assessments, and hosted a learning collaborative to discuss best practices, barriers to implementation, and other program-related concerns. Lastly, CHN evaluated outcomes for each agency that implemented the model, including on the scope of service and the number of advancement opportunities within the organization for NPs, as well as NPs’ levels of confidence and feelings of organizational support.