Nurse practitioners are seeking to expand primary care to millions of Americans under the new health law by asking the Obama administration to include them in the new plans. Although nurse practitioners (defined as an advanced practice registered nurse) are allowed to practice independently in 17 states and the District of Columbia, many insurers still do not accept them in their networks as primary care providers.
NP’s want to be able to bill insurers for their services, but insurers say that state laws about their ability to independently practice restrict these efforts. Although insurers say that they have taken other steps to use nurse practitioners to provide primary care services.
In order to increase their role in primary care, nurse practitioners want to focus on expanding their credentialing so that they can take full advantage of their training. Advocates state that nurse practitioners can perform many primary care services, usually assigned to a doctor, at a lower cost. Doctor groups disagree with this proposition, stating that they should stick to doctor-led teams. Also, some provider groups feel that without a team approach, patients will be at serious risk.
30 million Americans are expected to gain coverage in the next decade leading to questions about who will care for all the new patients. Nurse practitioners believe inclusion in insurer networks will help meet the demand for care because they go through a much shorter training period than physicians.
Opposition from insurers, doctors’ groups, and varying state laws are straining nurse practitioners efforts to expand their roles in primary care. Despite this struggle, nurse practitioners have made some progress in broadening their role.
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