Whether you’re a lover or a hater, the Trump administration undeniably gave a shout-out to nurse practitioners and physician assistants this week. In a press release titled “Reforming America’s Healthcare System Through Choice and Competition“, the U.S. Department of Health and Human Services, the U.S. Department of the Treasury, and the U.S. Department of Labor asked for changes to the current healthcare workforce, including the way NPs and PAs are allowed to practice.
The report outlines the way in which current state and federal laws and regulations discourage choice and competition in the healthcare market and makes recommendations to encourage these practices. One way to increase the number of choices available to consumers and increase competition in healthcare markets is by improving utilization of nurse practitioners and physician assistants. More progressive scope of practice laws will help to achieve this. The Trump administration’s report states “APRN’s scope of practice varies widely ‘for reasons that are related not to their ability, education or training, or safety concerns, but to the political decisions of the state in which they work'”. The report goes on to state that ‘when APRN access to the primary care market is restricted, healthcare consumers-patients and other payers-are denied some of the competitive benefits that APRNs, as additional primary care service providers, can offer’. Supervision and collaborative practice agreements raise the cost of care provided by nurse practitioners and limit the adaptability of healthcare providers.
Based on these assertions, Trump’s cabinet made the following recommendations to the president related to broadening scope of practice for nurse practitioners.
- States should consider changes to scope of practice laws that allow providers to practice to the top of their license, using their full skill set.
- Changes to reimbursement policies by Medicaid, Medicare and other payers that allow non-physician providers to be paid directly for their services.
- States should eliminate rigid collaborative practice and supervision agreements that are not justified by health and safety concerns.
Only time will tell if states follow the Trump cabinet’s policy recommendations. As with most political issues, scope of practice for nurse practitioners involves a web of competing interests – those of physician organizations, nursing organizations, government entities, insurance companies, lobbyists and the like.
What do you think of the Trump administration’s recommendations related to APRNs?
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