Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Joan Kearney


A Project to Improve Advanced Practice Provider Financial Metrics Through a Practice Management Program

This DNP project developed a practice management program for ambulatory Advanced Practice Providers (APPs) practicing in a large academic healthcare system with the goal to improve financial metrics. In 2020, Centers for Medicare and Medicaid Services (CMS) reported $25.74 billion in incorrect payments citing documentation errors and insufficiency as the common cause. The growth of the APP workforce necessitates APP practice management knowledge to avoid significant revenue loss since APPs collectively report lack of healthcare business knowledge. Twenty ambulatory APPs participated in a 12-week practice management program focused on visit code assignment, global procedural period, modifiers, charge capture, and revenue cycle management. A 10-minute podcast lecture for each concept was sent to participants’ mobile phones via text message every 2-weeks. Participants completed a pre- and post-program practice management knowledge assessment and a perceived self-efficacy survey. The participants received monthly productivity metrics. Average work relative value units (wRVUs) per session benchmarks for each participant were established and monitored during and for 2-months after the program. There was a highly significant improvement post -program in average total perceived self-efficacy of (t = 4.8695, p < 0.0001) and average total knowledge acquisition of (t = 2.579, p = 0.014). Areas within these domains also demonstrated significant trends in improvement. Mean wRVUs per session during implementation was found to be statistically significant (t = 2.63, p = 0.017). at 0.60 above benchmark. In conclusion, a short, focused practice management program improved APP practice management confidence and knowledge and increased in APP estimated financial productivity.


This is an Open Access Thesis.

Open Access

This Article is Open Access