Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners

The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Med...

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Bibliographic Details
Published in:Health Affairs Vol. 37; no. 6; pp. 908 - 914
Main Authors: Barnes, Hilary, Richards, Michael R., McHugh, Matthew D., Martsolf, Grant
Format: Journal Article
Language:English
Published: United States The People to People Health Foundation, Inc., Project HOPE 01.06.2018
Subjects:
Beneficiaries
Collaboration
Cross-Sectional Studies
Female
Health care
Health care delivery
Health care policy
Health Care Surveys
Health services
Humans
Interdisciplinary aspects
Internet
Male
Medicaid
Medical practices
Medicare
Nurse practitioners
Nurse Practitioners - legislation & jurisprudence
Nurse Practitioners - supply & distribution
Nurse's Role
Nurses
Outcome Assessment (Health Care)
Patient satisfaction
Patients
Physician assistants
Physicians
Physicians, Primary Care - organization & administration
Practice Patterns, Physicians' - organization & administration
Primary care
Primary Health Care - organization & administration
Quality of Health Care
Rural areas
Rural Health Services - organization & administration
Rural Population
Scope of practice
State policies
Trends
Uninsured people
United States
Urban Population
Welfare recipients
Workforce
United States
United States > US
Nurse Practitioners
Rural Health Care
Workforce Issues
Primary Care
Team-based Care
ISSN:0278-2715, 2694-233X, 1544-5208, 2694-233X
Online Access:Get full text
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Summary:The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008-16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery.
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ISSN:0278-2715
2694-233X
1544-5208
2694-233X
DOI:10.1377/hlthaff.2017.1158