As a record number of Americans enter retirement, many will move to small towns and rural areas across the U.S. seeking a warmer, quieter or more peaceful life.  But with physicians exiting primary care and Medicare reducing reimbursement rates for healthcare providers, who will provide healthcare for these aging individuals?

According a NPR, the 78 million Americans who fall into the “Baby Boomer” category may have difficulty finding medical care if they plan to retire in a small town over the next 20 years.  There are several reasons for this problem.  First, many primary care providers prefer to live in urban areas as they provide better schools and job opportunities for spouses.  Secondly, Medicare pays rural doctors less than physicians practicing in urban areas as their operating costs are lower (to see how this works, read my post on the RVU).  As Medicare continues to slash it’s reimbursement rates for physicians, the shortage of physicians will likely worsen.  Dr. Bruce Stowell reports that his clinic in Grants Pass, Oregon is not longer accepting Medicare

patients because Medicare pays only 45 percent the rate of commercial insurance carriers.  A survey in Oregon, showed that 19.1 percent of doctors have closed their practice to Medicare patients and 28.1 percent have restricted the numbers of Medicare patients they see.  Given these setbacks, who will provide care for America’s aging population?  Nurse practitioners of course!

Mark Pauly, professor of healthcare management at the University of Pennsylvania reports that “the Affordable Care Act puts a lot of emphasis on wellness programs and primary care; nurses, especially nurse practitioners, are intended to play a major role there”.  In states like Oregon and Washington, nurse practitioners can operate their own clinics independently of physician supervision.  For you as a nurse practitioner, this is great news.  Nurse practitioners are well equipped to provide primary care for the aging population in these communities.  As nurse practitioners, the shortage of primary care physicians is an excellent opportunity to expand the number of NP owned and operated clinics as well as advocate for laws increasing the abilities of NP’s to practice independently in other states.

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