Study: Increasing Scope of NP Practice Does Not Undercut Physician Reimbursement

One of the arguments physician opponents of the increasingly widening “scope of practice” some states grant nurse practitioners has been the perceived loss of potential reimbursements in a given market when both factions practice simultaneously. The given region is usually primary care-depressed in terms of actually physician numbers, and practice encroachment has long been a bone of contention in some circles.

Researchers are a bit closer to answering that issue, as a policy paper has not found evidence for any drop in phsyician payments for services rendered in areas in which advanced-practice nurses possess a greater degree of practice freedom.

“As we plan for the expansion of health care coverage to over thirty million people in 2014, the shortage of primary care providers will be one of the major challenges. As a result, it is important to systematically assess whether there are negative consequences for primary care doctors associated with an expanded role for nurse practitioners. Our study is a first step in that assessment. We found no evidence of negative economic impact on family physicians and internists in States that have already implemented reforms,” said lead researcher Patricia Pittman, Ph.D., associate professor in the Department of Health Policy in the GW School of Public Health and Health Services and the School of Nursing.

Framed against the backdrop of a sustained primary care shortage once the reform law kicks in, this argument bodes well for NPs who have benefited from states that have loosened practice barriers; but, the greater issue is whether this is reflective of another perception — at least among medical school grads: does it still “pay” to go into primary care?