Have Nurse Practitioners Reached a Tipping Point?: Interview of a Panel of NP Thought Leaders

Peter I. Buerhaus, PhD, RN, FAAN


Nurs Econ. 2010;28(5):346-349. 

In This Article

Opportunities in Health Care Reform

Buerhaus: That brings us to health care reform and the Affordable Care Act. What are the provisions in this legislation that will impact nurse practitioners?

Pilon: One provision calls for funding of nurse-managed health centers. There are significant funds for nurse-managed health centers to continue and expand the care provided to vulnerable populations. This funding will help nursing schools keep their facilities open so they can train tomorrow's providers. This is a big breakthrough for nursing schools. In addition, the rules create a higher level of accountability for what you do with the funding received, which I think is a good thing. The Act also provides new dollars for the health professions and not just in nursing, but any primary care provider trainee can get loan repayment and scholarships more readily. This will hopefully influence decisions of 3rd and 4th year medical students to attract them into primary care and help keep them there and hopefully involved in vulnerable population work. Taking care of this population is where NPs began and we should always be heavily involved, no matter what economic incentives are being offered in other populations as health reform moves forward.

Hansen-Turton: There is funding to increase innovations in health care delivery. Certainly, some of the CMS demonstration projects involving primary care could be NP driven or at least include NPs and advanced practice nurses. As state insurance exchanges are rolled out, there will be an opportunity for insurance companies to include NPs in primary care provider networks to ensure people have access to care. Otherwise, it could be embarrassing for the Administration if insurance companies do not contract with NPs and hence restrict access to care for people with insurance. That would risk another Massachusetts mess where people end up in emergency rooms for basic primary care because there is not enough primary care providers.

Hanson: I am very optimistic. There are so many opportunities for education, improved reimburse ment, and demonstration pilot programs, including the Medical Home, that fits perfectly for advanced practice nursing.

Esperat: One provision mandates an increase in nurse-midwifery reimbursement rates to 100% of physician rates. This has significant implications for nurse-midwifery practices and will increase the attractiveness of the CNM role.