The Client Challenge
The academic medical center and 500+ advanced practice providers (APPs) at UVA Health wanted to prepare for the Centers for Medicare and Medicaid Services’ (CMS) upcoming split/shared billing changes. Leadership also sought to reaffirm and elevate the role of APPs to propel clinical growth and access, and support inpatient coverage needs—which would positively impact financials in the wake of the policy change.
THE COST OF INCONSISTENT APP ROLES & EXPECTATIONS:
- Untapped ambulatory capacity
- Higher APP turnover
- Uncaptured revenue
- Higher labor costs
Navigating to Next: The Solution
Survey results found only 50% of APPs felt their skills were being fully utilized. Multiple opportunities were highlighted: lack of clear role expectations, insufficient team support, limited exam room availability, and burdensome administrative tasks. The challenges suggested support systems were needed for APPs to operate efficiently under the new CMS rules.
To begin, Chartis collaborated with department leaders to design, test, and establish expectations for APPs, including: (1) operating standards; (2) ambulatory and acute care models; (3) department-specific playbooks; and (4) a roll-out plan.
Chartis also established a Center for Advanced Practice (CAP) to support professional development and standardized financial arrangements between the provider group and medical center to enable APP billing. The CAP infrastructure was leveraged to integrate performance measurement systems, combine provider position reviews, and streamline credentialing.
The additional clarity on role division helped practices chart a path to both improving access to care and maximizing wRVUs attributed to each physician and APP under the new CMS rules.