Nurse practitioner scope of practice reform: rewriting the playbook in Pennsylvania : putting patients at the center
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Policy brief (Leonard Davis Institute of Health Economics)
- Author(s):
- Weiner, Janet, author
- Contributor(s):
- Leonard Davis Institute of Health Economics, issuing body. University of Pennsylvania. School of Nursing, issuing body.
- Publication:
- Philadelphia, PA : Leonard Davis Institute of Health Economics, January 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Nurse Practitioners Scope of Practice Patient-Centered Care United States
- Genre(s):
- Technical Report
- Abstract:
- Pennsylvania is one of 28 states that has not expanded the scope of practice in its licensure laws for certified registered nurse practitioners (NPs), who must maintain formal collaborative agreements with physicians to practice. For many years, proposals to update licensure and adapt it to make it more compatible with current models of collaborative care could not overcome legislative logjams. Often, these proposals were seen as primarily "turf wars" between NPs and physicians, without full consideration of the impact on patients and public health. Growing evidence indicates that these legal oversight requirements impair professional entry to practice, increase costs of care, impose administrative and cost burdens on health systems and NPs, and impede access to high-quality, cost-efficient health care. Both chambers of the Pennsylvania General Assembly acted to expand scope of practice during the 2019-2020 session--although to different extents. S.B. 25 would have expanded opportunities for NPs across the state, while a compromise amendment to H.B. 100 proposed a six-year pilot program that would have removed physician oversight requirements for NPs in primary care shortage areas only. Neither piece of legislation passed both chambers before session expired. A University of Pennsylvania analysis showed that H.B. 100, as amended, would have affected fewer than 50 NPs who now practice in these shortage areas, which have a combined population of more than 200,000 people. It would not have changed the practice restrictions on the vast majority of more than 11,000 NPs practicing across the state, often in rural and high-poverty areas. Since the legislation was introduced in 2019, the landscape for reform has shifted, as the COVID-19 pandemic rapidly transformed health care and revealed striking health disparities. Recognizing an opportunity to break the logjam, the University of Pennsylvania held a virtual workshop on November 20, 2020, bringing together researchers, health professionals, and consumers to chart a new path forward. This policy brief summarizes their recommendations to update scope of practice regulation to better meet the primary care needs of Pennsylvanians.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (2 unnumbered pages)).
- NLM Unique ID:
- 101777562 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101777562