How do State Regulations Impact the Nation’s Nurse Practitioner Workforce?

Feb. 10, 2015
Study to Identify Gaps in NP Workforce for Underserved Populations
Ying Xue

School of Nursing associate professor Ying Xue, D.N.Sc, R.N., will soon receive a $300,000 grant to examine how the nurse practitioner (NP) workforce is spread across the nation— especially in relation to underserved populations— and whether that may be affected by state scope-of-practice regulations.

Her project, the “Impact of State Scope-of-Practice Regulation on the Availability of Nurse Practitioners in Caring for Vulnerable Populations,” is being funded by the National Council of State Boards of Nursing (NCSBN),  a not-for-profit vehicle through which boards of nursing from all 50 states work to promote regulatory excellence for public health, safety and welfare.

Xue will examine national, state and regional data on NP distribution collected from 2009 to 2013. She says the findings will help policymakers identify the areas that would most benefit from changes to state regulations to help address health care disparities and improve health care quality and access.

NPs have long played a key role in providing accessible primary care to patients in underserved, low-income urban and rural areas across the country. Recent health care reform policies and initiatives, such as expanded insurance coverage and sizable capital investment in community health centers, have also created new opportunities for NPs to fill the growing need for primary care among these vulnerable populations.

However, the ability of NPs to practice to the full extent of their education depends on state scope-of-practice regulations, which vary considerably from state to state. For example, many states permit NPs to write prescriptions, while others do not.

As such, legislation affecting the number, availability and distribution of NPs is one of the most critical regulatory issues faced by states in providing high quality affordable care to their residents, especially those with high disease burden and limited access to care.

“Understanding how legislative and regulatory decisions can influence the nurse practitioner workforce and its ability to deliver primary care is essential for meaningful development of health policy,” Xue says. “By identifying these gaps in the nurse practitioner workforce that exist across the nation, we can work effectively to eliminate the inequalities in health and health care access that persist across racial and ethnic groups and socioeconomic classes.”