October 25, 2012
Sue Ducat
Director of Communications, Health Affairs
(301) 841-9962
sducat@projecthope.org Mike Warner
GYMR Public Relations
202-536-8101
mwarner@gymr.com     

Nurse Practitioners And Primary Care
           
Bethesda, MD -- A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=79&t=h&id=1643>  examines policy proposals that would allow nurse practitioners to practice to their full potential--and the extent to which the medical profession, policy makers, and patients are supportive of that effort. 
            
Currently, about 55 million Americans live in areas with shortages of primary health professionals, a situation that may grow worse as the Affordable Care Act increases access to insurance coverage and the population ages and chronic illness increases in prevalence. 
            
In nineteen US jurisdictions (eighteen states plus the District of Columbia), nurse practitioners--registered nurses who have also completed a postgraduate nursing degree--are allowed to diagnose and treat patients and prescribe medications without a physician's involvement. These practitioners and their capabilities help to fill the void left by the current shortage in some parts of the country of primary care physicians. There is also a growing body of research showing that patients value access to consistent care from one particular provider, whether a nurse or a physician.

• What's the debate? The brief discusses the main bone of contention: stringent "scope-of-practice" laws, which require nurse practitioners in thirty-two states to practice care under supervision of a physician, and thus restrict them from practicing on their own. It examines the current opposition by some physician groups to expanding nurse practitioners' roles and also sheds light on the 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, which recommends changes of state and federal laws to allow nurse practitioners to practice to the full extent of their education and training.
• What are the financial considerations? At the present time, Medicare reimbursements to nurse practitioners for the same services are 85 percent of those made to physicians. Although the Medicare Payment Advisory Commission found that there was no analytic foundation for this difference, revising the payment structure could increase overall Medicare spending if increased payment rates are not offset by savings in other areas.
• What's next? At the moment, many state legislatures are considering changes to licensure and scope-of-practice requirements for nurse practitioners. The lawmakers will have to weigh concerns from physicians about patient safety to discern whether those concerns have any validity--the evidence to date suggests that they don't--or primarily represent a concern about competition.
  

  About Health Policy Briefs  
 
Health Policy Briefs are aimed at policy makers, congressional staffers, and others who need short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

Previous policy briefs have addressed:   

• Pay-For-Performance <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=78&t=h&id=1643> . New payment systems reward doctors and hospitals for improving the quality of care, but studies to date show mixed results.       

- The Supreme Court and Health Reform <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=77&t=h&id=1643> . The future of federal-state programs is more uncertain now that the high court has limited the expansion of Medicaid.              

• Improving Care Transitions <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=76&t=h&id=1643> . Better coordination of patient transfers among care sites and the community could save money and improve the quality of care.

Sign Up For Health Policy Briefs   

Sign up for an e-mail alert about upcoming briefs at:
http://www.healthaffairs.org/1260_opt_in.php <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/1260_opt_in.php&t=h&id=1643>
 
The briefs are also available from the RWJF's Web site, at www.healthreform.org  <http://www.healthaffairs.org/alert_link.php?url=http://www.healthreform.org/&t=h&id=1643>
 
Please feel free to forward to any of your colleagues who are tracking health issues. And after you've taken a look, we would welcome your feedback at hpbrief@healthaffairs.org.
    
About Health Affairs                   

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears monthly in print, with additional Web First papers published frequently online at www.healthaffairs.org <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/> . You can also find the journal on Facebook <http://www.facebook.com/HealthAffairs>  and Twitter <http://www.twitter.com/Health_Affairs> . Read daily perspectives on Health Affairs Blog <http://www.healthaffairs.org/blog/> . Download weekly Narrative Matters podcasts on iTunes <http://itunes.apple.com/us/institution/health-affairs/id382118754&t=h&id=1643> .
    
About The Robert Wood Johnson Foundation  

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org <http://www.healthaffairs.org/alert_link.php?url=http://www.rwjf.org/> . Follow the Foundation on Twitter <https://twitter.com/rwjf>  or Facebook <http://www.facebook.com/RobertWoodJohnsonFoundation&t=h&id=1643> .

This email was sent to Diane.Skiba@ucdenver.edu. You are receiving this e-mail because you registered on the Health Affairs Web site. Click here to manage your subscription preferences: http://www.healthaffairs.org/1260_opt_in.php <http://www.healthaffairs.org/alert_link.php?url=http://www.healthaffairs.org/1260_opt_in.php&t=h&id=1643>

To ensure that you always receive Health Affairs Web content alerts, please add the e-mail address webmaster@healthaffairs.org to your address book.

Health Affairs - 7500 Old Georgetown Road, Suite 600 - Bethesda, MD 20814