Running head: PRACTICE MARKETING PLAN

Practice Marketing Plan

Stephen Karimi

University of Northern Colorado

NURS 690

PRACTICE MARKETING PLAN

Advanced Practice Registered Nurses demonstrate higher competency and independence within
various clinical settings ranging from hospitals to school-based community health clinics due to extensive
specialized training and education. APRNs hold masters, post-masters, or doctoral degrees. During their
training, APRNs are well equipped with skills and knowledge that enable them to assess patients
conditions, diagnoses disease, order various tests, prescribe medication, make appropriate referrals, and
teach patients, families, and communities about their health (NCSBN,n.d).
As the US health care system continues to change, the demand for health care providers, health
care costs, and the longevity of an aging population will dramatically continue to stretch, therefore
demanding a greater need for APRNs. Studies have shown that the APRNs are proficient to
deliver effective and safe care resulting in higher levels of patients satisfaction ((Horrocks, 2002).
Contrary to APRNs extensive education and clinical experiences, they continue to face
constraints that hinder them to provide comprehensive patient care. Some of the ongoing barriers
include; legislation, payment policies, professional tensions and regulatory and institutional restrictions.
To overcome the above barriers, it is imperative for every APRN to join in solidarity and reach out to
patients, families, and the general public in order to market the their roles and the value of the profession
as a whole. In order to market myself in todays health care system environment, I am going to use 4
concepts which will include; product, place, promotion, and price (Gallagher, 1996).
Dream Job
My dream job is to work as Family Nurse Practitioner in a well-established rural clinic setting.
The clinic ideally will provide more preventive medicine and less curative medicine. I was very fortunate
to rotate within different specialties during my clinical experience at UCHealth Longmont Clinic.

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Although my experience was great at UChealth Longmont Clinic, my interaction with a diverse patient
population was very minimal, therefore limiting my clinical experience with patients and families of
other cultures. After graduating from UNC and passing my certification for FNP, I wish to work in a
clinic that offers the following:
-

A well-presented demographic population.

Career and personal growth opportunities.

Continuing education assistance.

Facilitates therapeutic relationships with patients, families, and the community

it serves.

Supports my continuation of international medical mission.

Product

I have been working as RN for a period of 5 years. Throughout my career as RN I have worked
in 2 hospitals at different geographic locations and in variety of settings which included; Telemetry for 2
years, Mental Health/Developmental Disabilities/Addictive Diseases unit, Transition care unit with
hospice patients and also I have floated to orthopedic and medical surgical floors for a period of 3 years.
During this time I have done 6 global medical missions in Kenya. As a FNP student I maintained a good
therapeutic relationship with my patients, families, and staff during my clinical experiences.
Promotion

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Advanced Practice Registered Nurses should continue marketing their services to both the
medical community and also to the public as a whole. As we continue to grow our expertise, we
should be aware that being good in what we do is not enough to the current rapidly changing health
care system (Gallagher, 1996). As I continue on my career path as NP, I plan to promote myself in
the following ways;
1. Continue to develop relationships with my patients, families, other providers, and the
community as whole.
2. Continue using evidenced based practice along with collaborating and networking with
other APRNs.
3. Continue participating in regional, state, and national legislative processes.
4. I would request my name to appear in my clinics print and web advertising.
5. Create my own business card and brochure highlighting my skills along with my contact
information.
Place
My clinical experience at the UCHealth Longmont Clinic was exceptional. I had the opportunity
to work with a wonderful mentor along with excellent providers, and very supportive staff members. As
a new graduate I will feel more comfortable starting a career here since I have made great connections
with various providers. After several years working with the UCHealth Longmont Clinic, I expect to be
well equipped with more clinical experiences and great connections with other providers. I hope to carry
all that forward and serve a more rural community.

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Employer Contract
An employee contract is essential and has certain advantages over an informal employment
arrangement. A contract offers a certain degree of security, enables the employee to know what he or she
is entitled to do, along with the policies that will govern his/her job duties and responsibilities (Hamric et
al., 2014).
As a new graduate, before negotiating or signing a contract, I will have a predetermined list of
criteria of what I feel is negotiable and what I feel I can and cannot compromise. I plan to seek advice
from my mentor NP and other NPs that I have come to know at the clinic during my rotation. At the time
of interview, I will have other elements that I will consider during the negotiation of my contract which
will include; start date, the pay, benefits, continuing education, medical benefits, bonus opportunities,
retirement plans, sick, vacation, and personal time which will include time for my medical mission work.

Billing and Reimbursement

It essential for APRNS to understand the billing and reimbursement purposes (Buppert, 2012).
Most of the patients encountered by a Nurse Practitioner has third payer, and each of these payers
reimburse the nurse practitioner differently depending on each payers policies and rules that are set for
reimbursement (Buppert, 2012).
They are various major third-party payers such as Medicare, Medicaid, managed-care
organizations, indemnity insurance and other business contracts from other services that reimburse the
services rendered by Advanced Practice Registered Nurses (Buppert, 2012).

PRACTICE MARKETING PLAN

Medicare is a federal program that covers patients who are aged 65 years and old. It also covers
patients who are already enrolled and are disabled with social security disability benefits (Buppert, 2012).
Under Medicare policies NP may be reimbursed at a rate of 85% of the physician rate for the service
rendered (AANP, 2013).
When I start working, I plan to apply for a National Provider identification number for the
purpose of Medicare billing. Since I will be working for a larger clinic I hope the billing office at the
clinic will be submitting billing for each patients visit or procedure that I provide. I will also continue
consulting a medical billing office for evaluation and management coding at the clinic to ensure am not
overcharging or undercharging patients for the services rendered. I hope to get at least 1 days of training
with billing and coding personnel before start seeing the patients.
Medicaid is a federal program that is administered by the United States for mothers, children
who qualify based on poverty, and poor adults with disabilities for a short term (Buppert, 2012).
Medicaid reimbursements vary from state to state but In Colorado, Nurse Practitioners are reimbursed by
Medicaid 100% (Rhonda, 2016).
Physician/ Nurse Practitioner Mentorship
After receiving my provisional prescriptive authority and Drug enforcement agency number
(DEA), I plan to complete 1000 hours of mentorship with a physician or Nurse Practitioner as required
by regulatory state Board of Nursing in Colorado (Colorado Department of Regulatory Agencies, 2016). I
will outline my plan related to medication prescribing, how communication will be done between two of
us, and how often our meetings will be scheduled. I plan to meet with my mentor at least once a week to
discuss my progress. During the meetings I will have a list of questions and other concerns. I plan to

PRACTICE MARKETING PLAN

continue discussing my various findings and share my thought processes with my mentor throughout my
mentorship period. Upon completing of 1000 hours I will ask my mentor to sign my document to
attestation that I have successfully completed my time prior to applying for fully prescriptive authority.
My articulated plan will include; how I will maintain safe prescribing of medication, when to
seek guidance from my mentor, mechanism for my referral and consultation for my patients with
complex health needs, decision support tool and continues documentation of ongoing education in
pharmacology.
Contract Consideration
As a new graduate, I am determined to agree to work 4 days a week, 8-10 hours per day and 4850 weeks a year. I will negotiate to see a total of at least 12-14 patients each day during my first year. At
the one year milestone, I will have already completed the 1000 hours mentorship. My second year, I plan
to increase my patient load to 14-16 patients. My first year I am determined to work with annual salary
ranging $85,000 while completing my 1000 mentorship hours. Other cost that I will consider in my
contract will include; malpractice insurance, health insurance, retirement and 401k plan.
During the first year I will see a total of 56 patients per week multiplied by 50 weeks equaling a
total of 2800 patients per year. The primary payer for LUHealth Longmont Clinic includes; Medicare,
Medicaid and private insurance. Due to variability of reimbursement among the payers, I am going to use
Medicare reimbursement rates to determine my yearly generated revenue in the clinic.
The calculation of my yearly income will be based on level 3 and 4 coding for established office
visits only. Assuming that majority of the patients that I will seeing my first and second year will be
Medicare patients. Sixty percentage will be billed at level 3 (99213) and forty percentage will be billed

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at level 4(99214). In 2015, the Medicare reimbursed physician at $ 73.35 per visit for patients billed at 3
level and $ 107.70 per visit for those billed at level 4 (America Academy of Sleep Medicine, 2015).
Given that APRNs are reimbursed 85 % of the physician fee for service rendered, the NP will receive
roughly $ 62.75 and $ 90.62 for level 3 and 4 respectively.
At the end of the year, I expect to see 2800 patients per year. 1680 patients will be billed at level
3 and 1120 patients billed at level 4. The expected revenue for combined levels per year will generate
approximately $205,234. This does not put into consideration Medicaid, private insurance and private
pay.
Overhead cost for the clinic
The costs for the clinic may include; indirect materials, utilities, rent, employee salaries and
benefits, office furniture and supplies, computers and relevant software, advertising expenses (web and
print), and website hosting fees. The projected overhead contribution will account for 56% of the total
revenue generated per year (Nelson, 2016). The overhead percentage cost for the 2rd year will remain
Constant.
During the first year the total overhead cost contributed toward the clinic will be 56% of $
205,234, which will be $ 114,931. If everything remains constant the second year overhead cost will
total $131,350. Other cost that will be deducted from my generated revenue will be physician consultant
fee of 10% of the remaining amount after overhead cost deduction. The first year the physician
consultant fee will be $ 9,030 and the second year will total $10,320. I wish to work at a clinic that
doesnt require a physician consultant fee.

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The salary for a nurse practitioner in Colorado varies with industries. According to Nurse Journal
Social Community for Nurses World, in Colorado a NP annual salary averages $84,000 which is 13%
lower compared to national average.
Below is my first and second years estimated generated revenue, overhead cost, physician
consultant fee and projected annual salary.

First year estimated generated revenue

Visit code

Patients

Patients seen the

NP reimbursement

Total

seen per

first year

per patient

Reimbursement
1st year

week
99213

37

60% of total
patients
99214

$61.75

$114,164

$90.62

$86,089

1850 patients
19

40% of total
patients
Total

37X50 weeks=

19x50weeks=
950 patients

56 patients

2800 patients per

$ 200,253 per

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10

year

year
$100,127

overhead cost
56 % of total
revenue
Physician

$10,064

consultant fee
10%
My Estimated

$90,063

1st
income

2rd Year estimated generated revenue

Visit Code

99213

Patients

Patients seen

NP reimbursement

Total

seen per

2rd year

per patient

reimbursement 2rd

$61.75

year
$118,560

$90.62

$115,994

week
38 patients

60% of total
patients
99214

1920
patients

28 patients

1280

40% of total

patients

patients
Total

3200

$234,554

patients
Overhead cost 56

$131,350

% of total revenue
Physician

$10,320

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consultation fee
10%
My estimated 2rd

$92,884

yearly income

Performance Evaluation
As a new graduate, entering into the profession of health care provider can be intimidating and
unnerving at times. The first year will be important for me to have a mentor that I can rely on as I
continue to grow in my career as a competent nurse practitioner.
The first year I plan to have informal and formal meetings with my mentor to discuss the areas
that I need to improve and questions that I might have. Informal meetings will be held every two week
and formal meeting will be held after every 4 months. During my first year at the clinic I expect to yield
low revenue because of low volume of patients seen and billed at less level of coding with minimal
procedures.
As an NP, learning is a continual process and I need to be aware that business is part of what I
do. In the health care business, the providers performance is critical and has a variety of criteria to be
assessed by such as productivity, clinical decision making, utilization and patient satisfactions are used to
evaluate the outcomes (Buppert, 2012).

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Health plan Employer Data and Information set (HEDIS) and National Committee of Quality
Assurance (NCQA) are tools for clinical performance that evaluate if providers comply with current
measures and benchmarks (Buppert, 2012). I plan to continue revisiting the guidelines outlined by
United States Preventative Services Task Force (USPSTF) to make sure I continue complying with
current recommendations.

Timeline for Marketing Plan

My marketing plan will begin one month prior to my graduation on May, 2016. I plan to start
visiting different clinics websites for Nurse Practitioner job postings. Two weeks before the end of my
clinical rotation I plan to make an appointment with a provider recruiter at UCHealth Longmont Clinic.
Additionally, I am planning to consult with the current NPs working for UCHealth at the Longmont clinic
to express my interest working there and request if opportunities arise that they will refer me for the
position.
One week before my graduation, I set an appointment with the Longmont United Hospital
Centura Health vice president in charge of strategic planning and clinic operations for Milestones
Medical Group to discuss possible employment after I pass my certification. After my graduation, I plan
to continue searching for NP position in different geographical regions across Colorado using different
networking on social media and engaging in NPs promotional activities.

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References
APRNS in the U.S. (n.d.). Retrieved April 9, 2016, from NCSBN:
https://www.ncsbn.org/aprn.htm
Board of nursing: News. (2016). Retrieved April 9, 2016, from Colorado Department of
Regulatory Agencies: https://www.colorado.gov/pacific/dora/Nursing_News
Buppert, C. (2012). Nurse practitioner's business practice and legal guide (4th ed.). Sudbury,
MA: Jones and Bartlett Learning.
Evaluation and management services 2014 vs 2015 national payment and RVU comparison.
(2015). Retrieved from American Academy of Sleep Medicine:
http://www.aasmnet.org/resources/articledocs/eandmpaymentrvucomparison.pdf

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Fact sheet: Medicare reimbursement. (2011). Retrieved April 9, 2016, from American
Association of Nurse Practitioners: https://www.aanp.org/legislation-regulation/federallegislation/medicare/68-articles/325-medicare-reimbursemen
Gallagher, S. (1996). Promoting the nurse practitioner by using a marketing approach. Retrieved
from PubMed- NCBI: http://www.ncbi.nlm.nih.gov/pubmed/8710255
Hamric, A., Hanson, C., Tracy, M., & O'Grady, E. (2014). Advanced practice nursing: An
integrative approach (5th ed.). St. Louis, MO: Elsevier Saunders.
Horrocks, S. (2002). Systematic review of whether nurse practitioners working in primary care
can provide equivalent care to doctors. BMJ, 324(7341), 819-823.
Naylor, M., & Kurtzman, E. (2010, May). The role of the nurse practitioner in reinventing
primary care. Retrieved April 8, 2016, from HealthAffairs:
http://content.healthaffairs.org/content/29/5/893.full
Nurse practitioner salary by state. (2015). Retrieved from Nurse Journal:
http://nursejournal.org/nurse-practitioner/nurse-practitioner-salary-statistics/.