The Effect of Nurse Practitioner Scope of Practice Laws on Health Care Utilization and Health: Evidence from Law Changes and Patient Moves

The extent to which nurse practitioners (NPs) are allowed to provide health care services independent of physicians varies substantially across states. Recently a number of states have passed laws that increase NP’s scope of practice. We first document cross-sectional variation in the type of care provided physicians and NPs. We then use detailed Medicare claims data and both state law changes and cross-state patient moves to estimate the effect of NP scope of practice on the quantity of medical care, the type of medical care, and patient health. We find that greater scope of practice increases new office visits; has little effect on the number of other office visits; and reduces opioid prescriptions, ER visits, inpatient admissions, and readmissions.