Role of Nurse Practitioners in Health Care Reform By LaToyia 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