Some plans refuse to credential nurse practitioners as primary care providers. (AP Photo/John Smierciak)

Health Affairs, an academic journal that helps shape U.S. health policy debates, has published a “health policy brief” on the role of nurse practitioners in primary care.

In the article, Amanda Cassidy talks about the idea that states may move to address concerns about the supply of primary care providers by expanding the role of nurse practitioners.

Cassidy cites figures from the National Conference of State Legislatures indicating that state lawmakers had introduced 245 scope-of-practice bills as of February.

In August, Massachusetts Gov. Deval Patrick, D, signed a health cost control bill that will expand the role of physician assistants and nurse practitioners in the state.

Many drug stores now provide checkups, immunizations and other basic care through in-store clinics run by nurse practitioners.

Cassidy notes that nurses, patients and researchers who have studied the performance of nurse practitioners tend to support the idea of expanding the nurse practitioners’ role. 

Some physician groups have argued that nurse practitioner programs could put patients at risk, by increasing the likelihood that patients will see providers who lack the training necessary to identify some types of problems.

In 2009, only about half of private managed care plans were letting nurse practitioners work as in-network primary care providers, Cassidy says.

Allowing more use of nurse practitioners could save money, even if plans paid the practitioners as much as they pay doctors, because researchers have found that the nurse practitioners tend to order fewer tests, Cassidy says.

New health services access programs funded by the Patient Protection and Affordable Care Act of 2010 (PPACA) may help expand the role of nurse practitioners, because many programs are using nurse-led clinics to provide care in underserved areas or provide commonly needed services in locations such as retail stores, Cassidy says.

PPACA also provides $30 million in nurse practitioner training funding, Cassidy says.

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