Announcement from David Skalka, President of UNP

Dear UNP Members,

As I reflect on our organization and last year's accomplishments, it is with heartfelt gratitude I thank those who have served before me. Over the years, many NPs in our state have selflessly served us all as they furthered the organization and above all the NP profession. NPs serve patients and quietly face barriers each day when providing health care services. We are very fortunate to enjoy a fairly unrestricted practice environment, thanks to those who have led UNP, especially in the early years of the organization. The top priority of my Presidency is to make advances on the contributions of the past. The major threats to our profession and to our growth are reimbursement parity and full practice authority (FPA). Full Practice Authority is certainly the most heated area of NP advocacy and elicits strong reactions from all parties. While we are all pestered and some are quite hindered by the mandatory Consultation & Referral Plan, the Utah Supreme Court basically marginalized the plan in a recent ruling in the Rodier case published in January. Our physician colleagues are seeing the scare tactics and erroneous debates utilized to prevent FPA rapidly erode as the public is more and more aware of our record of safety and high quality health care. Surrounding states have all passed FPA bills which will only strengthen our case as Utah strives to liberate our profession from control and manipulation by outside sources so that we might offer the full array of services for which we are educated, trained, and certified.

Achieving FPA will only take us so far, however. It is imperative each of us understands that corporations such as The Minute Clinic, IHC, U of U, Kaiser Permeate and many others are negotiating with insurance companies for more select panels and some are insisting on reduced reimbursement for NPs even when providing the same services as physicians. The result may likely be a decrease in NP acceptance on future panels and our reimbursement will continue to fall.  With this in mind, if you are on an insurance panel I urge you to do all in your power to re-credential on time so that you maintain your ability to receive reimbursement.  Second, if you are considering purchasing a practice or going into private practice, empaneling should and must be a critical part of the negotiation.  I would like to offer a few business pearls. The most important element to know in any private practice is cost per patient.  This will give you an idea of what your profit should be when compared to revenue per patient.  Finally, help others develop their own private practice.  As the saying goes, "There is safety in numbers."

Please keep in mind that you are integral to any business model. You are where "the rubber meets the road."  You are the reason the patient comes to the practice. You are the reason the business is even in business. Administrative staff and support staff are important, but at the end of the day, the patient is there to see you and these staff members do not bill for or generate revenue. No other entity in the business can do what you do. Having said all of this, remember you will ultimately be the one named in litigation if something goes wrong. With these concepts in mind, negotiate your wage intelligently. It is with all the fervor I possess that I wish to stress the importance of negotiating an equitable wage. DO NOT sell yourself short of your true value. When you do this, you hurt the profession and negate the contributions of those who have sacrificed so much for your practice and you limit the future of NPs in Utah.

As Registered Nurses, we routinely undersold our services because our revenue was captured by the global entity. As NPs, WE ARE PROVIDERS! Insist on being paid as a provider like your physician counterpart does. You have the same liability as your physician counterpart. Why should you be paid less? The jury will award the same judgment against you as they would your physician counterpart for the same mistake.

David Skalka, MS, JD, FNP-BC, UNP President