--- title: "Primary care NP management of teen behavioral health. | Sutter Health" description: "A primary care NP could be a cost-saving and pt-centered way to reduce the burden on PCPs while meeting teen behavioral health needs." url: "https://www.sutterhealth.org/research/publications/primary-care-np-management-of-teen-behavioral-health-1055312814" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Primary care NP management of teen behavioral health. # Primary care nurse practitioner management of adolescent behavioral health. Dillon EC, Erlich KJ, Li J, Li M, & Becker DF. _Am J Manag Care. 2020 Sep 1;26(9):e295-e299. doi: 10.37765/ajmc.2020.88495._ 2020-09-01 ## Abstract Objectives: To determine the personnel costs and revenue generated by embedding a behavioral health nurse practitioner (BHNP) in primary care clinics to evaluate and manage adolescent behavioral health needs. Study design: We estimated personnel costs and revenue from a quality improvement project undertaken at 4 clinic sites between August 1, 2016, and July 31, 2018, at a large multispecialty medical group in northern California. Methods: Costs were estimated by identifying the actual hours spent by the BHNP and for medical assistant (MA) support and using Bureau of Labor Statistics national data on wages and benefits. Revenue was estimated by analyzing Current Procedural Terminology (CPT) codes for BHNP visits from the Epic electronic health record and corresponding relative value units (RVUs), based on 135% of 2018 nationally unadjusted Medicare rates. Results: We estimate 2-year revenue of $144,449 and personnel costs (salary + benefits) of $90,431. The BHNP work totaled 1083 hours, and MA support totaled 312 hours. Using a nurse practitioner wage of $53.70/hour and an MA wage of $16.95/hour, total salary costs were $63,451; we then added benefits costs. Using the CPT codes assigned to the 768 encounters with 207 unique patients, we estimated generation of 1640 RVUs and total revenue of $144,449. Conclusions: This analysis found that personnel costs ($90,514) of a primary care-embedded BHNP are 63% of the potential revenue generated ($144,449). This analysis suggests that a primary care BHNP could be a cost-saving and patient-centered way to reduce the burden on primary care providers while meeting the growing needs of adolescents with behavioral health needs. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/32930559/) ## Research topics - [Child and Adolescent Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Child+and+Adolescent+Health%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Variability in engagement and progress in efficacious integrated collaborative care for primary care patients with obesity and depression: within-treatment analysis in the RAINBOW trial.](https://www.sutterhealth.org/research/publications/obesity-depression-rainbow-trial-within-treatment-analysis-1055312741) Lv N, Xiao L, Majd M, Lavori PW, Smyth JM, Rosas LG, Venditti EM, Snowden MB, Lewis MA, Ward E, Lesser L, Williams LM, Azar KMJ, Ma J. PLoS One. 15(4):e0231743. doi: 10.1371/journal.pone.0231743. eCollection 2020. 2020 Apr 21 - Publication ### [Effect of long-term antibiotic use on weight in adolescents with acne.](https://www.sutterhealth.org/research/publications/effect-long-term-antibiotics-on-wt-in-teens-acne-1055312377) Contopoulos-Ioannidis DG, Ley C, Wang W, Ma T, Olson C, Shi X, Luft HS, Hastie T, Parsonnet J. J Antimicrob Chemother. pii: dkv455. \[Epub ahead of print\] 2016 Jan 17 - Publication ### [Determinants of antidepressant treatment compliance: implications for policy.](https://www.sutterhealth.org/research/publications/determinants-antidepressant-tx-compliance-1055312587) Tai-Seale M, Croghan TW, Obenchain R. Med Care Res Rev. 57(4):491-512. 2000 Dec 01 - Publication ### [Assessment of body mass index and association with adolescent preventive care in U.S. outpatient settings.](https://www.sutterhealth.org/research/publications/assess-bmi-teen-outpt-preventive-care-1055312947) Ma J, Xiao L. J Adolesc Health. 2009 May;44(5):502-4. doi: 10.1016/j.jadohealth.2008.10.001. Epub 2008 Nov 22. 2009 May 01 - Publication ### [Adult obesity and office-based quality of care in the United States.](https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917) Ma J, Xiao L, Stafford RS. Obesity. 17(5):1077–1085. 2009 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/primary-care-np-management-of-teen-behavioral-health-1055312814#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Primary care NP management of teen behavioral health."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/primary-care-np-management-of-teen-behavioral-health-1055312814#medicalscholarlyarticle","name":"Primary care nurse practitioner management of adolescent behavioral health.","headline":"Primary care NP management of teen behavioral health.","abstract":"Objectives: To determine the personnel costs and revenue generated by embedding a behavioral health nurse practitioner (BHNP) in primary care clinics to evaluate and manage adolescent behavioral health needs. Study design: We estimated personnel costs and revenue from a quality improvement project undertaken at 4 clinic sites between August 1, 2016, and July 31, 2018, at a large multispecialty medical group in northern California. Methods: Costs were estimated by identifying the actual hours spent by the BHNP and for medical assistant (MA) support and using Bureau of Labor Statistics national data on wages and benefits. Revenue was estimated by analyzing Current Procedural Terminology (CPT) codes for BHNP visits from the Epic electronic health record and corresponding relative value units (RVUs), based on 135% of 2018 nationally unadjusted Medicare rates. Results: We estimate 2-year revenue of $144,449 and personnel costs (salary + benefits) of $90,431. The BHNP work totaled 1083 hours, and MA support totaled 312 hours. Using a nurse practitioner wage of $53.70/hour and an MA wage of $16.95/hour, total salary costs were $63,451; we then added benefits costs. Using the CPT codes assigned to the 768 encounters with 207 unique patients, we estimated generation of 1640 RVUs and total revenue of $144,449. Conclusions: This analysis found that personnel costs ($90,514) of a primary care-embedded BHNP are 63% of the potential revenue generated ($144,449). 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