Originally from the West Coast, I wasn’t quite sure what to expect when I relocated south of the Mason Dixon line. There were certainly new foods to try- grits, okra and fried pickles to name a few. Country music, a staple in Tennessee, was one of my favorite discoveries as a result of my move. The charm of the south drew me in, from rolling green hills to hot and humid summers spent at the lake. Once I made my move, I never looked back.
As a nurse practitioner, on the other hand, there are some not-so-favorable aspects of living in the southern states. The job market for NPs is notoriously poor in the south. The deeper into the region you go, the more unfavorable your employment prospects. But, why?
1. Scope of Practice Laws
Scope of practice laws are state-specific sets of regulations that govern the way nurse practitioners practice. One of the primary regulatory stipulations these laws may make is that of a requirement for nurse practitioners to collaborate with or be supervised by a physician. Scope of practice laws may also dictate the way NPs are allowed to prescribe, further affecting their efficacy in practice.
In general, scope of practice regulations for nurse practitioners are stricter in southern states. This means that employers must jump through more hoops to use NPs in their facilities. Increased administrative responsibilities and decreased utility in practice as a result of such regulations means that salaries for nurse practitioners are lower and fewer job opportunities exist for nurse practitioners in the region.
Although there are fewer job opportunities for nurse practitioners in the south, there are a number of reputable NP programs in the area. Nashville, TN alone, for example, is home to several universities such as Vanderbilt, Tennessee State University, and Belmont that give rise to a number of new professionals each year. Nurse practitioners in Birmingham, AL experience a similar situation. The University of Alabama Birmingham has a large NP program, so the immediate and surrounding areas are saturated with providers. Graduates who intend to stay local upon completion of their program have a difficult time landing jobs.
3. Reimbursement Practices
Often, nurse practitioners are reimbursed at lower rates by payers than physicians. Medicare works in this manner for example, reimbursing NPs at 85% of the physician schedule for services rendered. While Medicare reimbursement rates apply nationally, states also have their own reimbursement considerations.
Private insurance companies may have more or less favorable reimbursement for nurse practitioners depending on the geographic area. Medicaid policies are similar. In Illinois, for example, NPs are reimbursed at 100% of the physician rate by the state’s Medicaid program – a win for NPs and their employers. In contrast, Kentucky’s Medicaid program reimburses NPs at just 75% of the physician rate making nurse practitioners a less attractive prospect in the area.
Together, these factors equate to some difficult job searching for nurse practitioners in the south.
How’s the job market for NPs in your area?
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