Study: APRN Scope-of-Practice Restrictions Are Costly to the Economy
A new study from a Duke University research center finds that the North Carolina economy takes an annual $430 million hit because of scope-of-practice restrictions on advanced practice registered nurses (APRNs).
Christopher Conover, PhD, of the Duke Center for Health Policy and Inequalities Research, writes that, in general, “North Carolina has a more restrictive regulatory climate regarding APRNs than most other states.” He notes, for example, that “North Carolina is one of only 21 states that impose the highest level of restriction on NPs , requiring a collaborative practice agreement with a physician both for diagnosis and treatment as well as prescribing medications.”
He goes on to calculate the likely economic impact of such restrictions, noting that other research on the safety and quality of care provided by APRNs has “concluded that APRN practice outcomes are equivalent or better than those of physicians,” and that APRN care is less expensive than physician care. Moreover, training costs and compensation are lower, he points out.
Conover has created an economic model that assesses the impact of loosening APRN restrictions, accounting for the cost of care and the likelihood that fewer restrictions would generate more jobs for APRNs in the state. He concludes that APRN regulatory reform would generate increased state tax revenues of at least $20 million per year, and save at least $430 million in health care costs annually. In addition, reform would ease the physician shortage in the state, particularly in certain specialty areas of practice.
“Modernizing APRN regulations has the potential to positively impact health care access, quality, and cost,” Conover told the Triangle Business Journal. “It is rare that any policy change offers gains across all three major dimensions of the North Carolina health system’s performance.”
The study was funded by a grant from the North Carolina Nurses Association and is published on the Center for Health Policy and Inequalities Research website.