Nurse practitioner regulations, workforce supply, quality of care, and access to care
Ongoing reports of shortages of primary care providers have led a growing number of policymakers to consider expanding the utilization of other providers, including nurse practitioners. This session considers the relationship between regulations that restrict the scope of practice of nurse practitioners (NPs) and their supply, quality of care, and access to care. The first paper, “Predictors of NPs working outside primary care in rural areas” (Joanne Spetz), focuses on rural NPs, Prior research has found that NPs in rural areas are more likely to provide primary care than those in urban areas. This paper uses the National Sample Survey of Nurse Practitioners to explore the predictors of rural NPs working in other fields. The second paper, “NP/MD prescribing and medication adherence: Evidence from Medicare” (Ulrike Muench), explores whether there are differences in medication adherence among Medicare Part D enrollees based on whether the prescriber is an NP or a physician. This paper has clear implications for the ability of NPs to provide good-quality patient care. The third paper, “Provider Access and Health Insurance Take-Up After the Affordable Care Act” (Victoria Udalova), asks whether individuals are more likely to purchase health insurance made available to them through the Affordable Care Act if the supply of NPs is high and NPs can practice independently. Her results suggest that consumers can assess whether the supply of providers is adequate when making insurance purchase decisions. Together, these papers provide evidence to policymakers regarding the importance of NP regulations in meeting health care needs.