Independent NPs could save California $1.8B, increase care access

California could save $1.8 billion in healthcare costs over the next 10 years if nurses were allowed more scope of practice, according to a new report issued by the Bay Area Council Economic Institute.

The institute concluded that due to the increase of 3.3 million Californians covered under the the Affordable Care Act and Medi-Cal, allowing nurse practitioners (NPs) to practice independently from doctors was "one of the most effective steps" the state can take to increase access to primary care providers. 

In addition to the projected savings, the report found that expanding the scope of practice would cause the number of NPs to jump 24 percent and allow more rural and underserved communities to gain care, according to an announcement.

The number of NPs in California more than doubled from 8,240 in 2004 to more than 17,000 in 2008, and now represent almost 6 percent of nurses in the state, according to the report. NPs were more likely to care for younger, female and non-white patients than doctors. They also are more likely to care for disabled, Medicare and Medi-Cal patients.

There would be approximately 4,000 more practicing NPs in the state if California lifted restrictions that they provide care only under the supervision of physicians, according to the report. Researchers estimate that granting full authority to NPs would result in an additional 2 million preventve care visits across the state each year, a 10.3 percent increase, while lowering costs.

"It's clear from this report that allowing nurse practitioners to practice the healthcare they've been trained for is a key to making the Affordable Health Care Act work effectively in California," Beth Haney, president of the California Association for Nurse Practitioners, said in the announcement. "It's time the legislature realize the cost savings increase in access and improvement in quality that will come from changing the law to remove the barriers to practice for nurse practitioners in California."

Other states have already lifted NPs restrictions. Starting in 2015, NPs in New York will no longer need a written practice agreement with a doctor in order to practice indecently, FierceHealthcare previously reported. And this week the Connecticut House of Representatives approved a bill that would give NPs greater independence to diagnose and treat patients without doctor supervision, according to the Hartford Courant.

However, not everyone agrees that NPs should have more scope of practice. In New Jersey, doctors oppose a bill allowing advanced practice nurses to issue death certificates to patients under their care, saying physicians are better equipped to make complex determinations about the cause of death.  

To learn more:
- here's the report
- read the announcement
- here's the Hartford Courant article

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