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Expanding The Practice Authority for Florida’s Nurse Practitioners

By 2030, Florida is expected to need an additional 4,671 primary care physicians. This shortage ultimately will result in limited access to care (especially in rural areas), higher healthcare costs, and reducing the quality of life for all. Floridians will start to experience the effects in the foreseeable future if a solution is not implemented. A proven cost-effective solution is to remove overly restrictive statutory barriers and allow nurse practitioners to practice to the full extent of their education and training.

A nurse practitioner (NP) is a registered nurse with additional training and education – essentially a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, and  formulate and prescribe treatment plans.

NPs practice authority varies widely across the U.S. In states such as Oregon, Arizona, Colorado, Minnesota, Iowa, and Wyoming, NPs can practice in accordance with their advanced level of preparation, experience, and certification, while in more populous states, such as California, Texas, and Florida, NPs are limited in their ability to provide care. It has been demonstrated in other states that by expanding an NPs scope of practice, there is more access to primary care services, and it can help to reduce costs. Additionally, robust evidence suggests that NPs provide safe, high-quality, and cost-effective healthcare. A 2015 study by Columbia University concluded that NPs are well-positioned to provide safe and effective primary care services and very few differences were found between care provided by a primary care practitioners and a NP. There is strong evidence that patients under NPs have higher satisfaction, fewer unnecessary emergency room visits, fewer hospital readmissions, and fewer preventable hospitalizations compared to patients under doctors.

By removing barriers that limit NPs’ scope of practice, Florida can attract more NPs to the state, which will add more value to local economies. A 2010 OPPAGA study found that allowing Florida’s Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) to practice to the full extent of their training and education would save the state up to $339 million across the entire health care system. The increased revenue creates full- and part-time employment opportunities and wages, salaries, and benefits for additional clinical staff. A 2016 economic impact study on the value added by NPs in rural America found that NPs added 4.4 local jobs to rural economies from a clinic and 18.5 local jobs from a community hospital. Considering there are 30 rural counties in Florida, expanding a NP’s scope of practice will help to provide quality cost-effective health care to the estimated 716,213 Floridians living in rural counties.

The Florida House and Senate are moving proposed bills relating to expanding the autonomy of a NP’s practice within the state. Not only are NPs with expanded scope of practice needed in Florida rural areas, they are also needed throughout the state to reduce the effect of physician shortages. If Florida expects to continue providing quality primary care services to Floridians, lawmakers need to give NPs more autonomy to practice in primary care health professional shortage areas.

Author: Shannon Belmont

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