Role of Nurse Practitioners in Health Care Reform

ByLaToyia Floyd

National Institute for Health Care Reform: Research Brief 13

Physician Shortage

•Real or Nominal Physician Shortage•Effected segments of health care

▫Primary Care•Complicating Factors

▫Aging Population▫Increase in population with health care

coverage via PPACA 2010

Major Issue

•Access to Quality Primary Care Services▫Chronic Disease Management▫Healthcare Coordination and Integration

•Liability and Quality

Substitution of NPs and PAs•Education for NPs

▫Registered Nurses▫NP: Master’s Level degree

Clinical education▫Doctorate of Nursing Practice (DNP)

Clinical leaders•Education for PAs

▫Various Bachelor Degrees▫PA: Master’s Level Degree

Clinical education Direct supervision by MD

NP Scope of Practice

•Direct Physician Supervision•Physician Oversight

▫Collaboration Agreement•No Direct Oversight•Variation between State Laws and Payer

Restrictions▫Reimbursement rates

Scope of Practice

Supply/Demand Effects

Barriers to Entry/Restrictions