| This is a descriptive, exploratory study to examine and analyze the compensation arrangements that nurse practitioners enter into with managed care organizations/plans, either directly or through their employers, and to describe the incentives that are included in those arrangements. The perceptions of the surveyed nurse practitioners related to satisfaction, goal conflict, and changing practice patterns associated with their compensation arrangements were also analyzed. The data collection instrument was developed by the investigator and completed by 363 adult and family nurse practitioners. A panel of content experts and a pilot study was used to assess the validity and reliability of the survey instrument. The collected data was statistically analyzed using descriptive nonparametric statistical procedures. A descriptive qualitative approach based on content analysis was used to determine the types of conflicts experienced by nurse practitioners working in the managed care environment and other issues related to their compensation arrangements.; The findings of the research study confirm the results of earlier studies that demonstrated that the majority of primary care practitioners are practicing in the managed care environment as employees with compensation arrangements that provide them with a fixed salary. Thirty percent of the sample reported they had variable compensation arrangements with levels of compensation subject to meeting various organizational or employer goals.; The experiences of this study's sample also demonstrate primary care nurse practitioners practicing in the managed care environment may anticipate experiencing one or more management strategies designed to influence their clinical practice, and/or to monitor access to services and the quality of care provided. |
