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Why Scope of Practice is Important to Nurse Practitioners 

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The nurse practitioner scope of practice in your state determines the limits of your medical license and sets boundaries to the care you’re empowered to deliver, crucial information for a new nurse practitioner independent practice.  

While you may have developed a working idea of the scope of practice, it is worth double-checking as you begin planning your new nurse practitioner practice endeavor. The details can be misinterpreted within the nurse practitioner scope of practice for each state, especially in situations where a nurse practitioner has relied on others to referee the guidelines of their work. Nurse practitioners can find themselves working in situations that place them in a position to possibly breach their nurse practitioner scope of practice.  

The issue is more complicated for nurse practitioners who practice in more than one state since SOP regulation among states, even within the three general levels of regulation, is inconsistent. 

As passionate champions of quality care, nurse practitioners are well served by clear guidelines on the scope of care they’re able to provide, making sure they’re performing not only to the best of their ability but also to the limits of the law.   

NP Discretion Encourages Better Quality of Care 

Studies indicate that narrowing the scope of care for nurse practitioners, such as in the 29 states requiring nurse practitioners to have physician oversight, limits high-quality, accessible care.  

States with the least restrictive nurse practitioner scope of care regulations have 2.5 times greater likelihood of patients receiving primary care from nurse practitioners than the most restrictive states.  Given nurse practitioner’s reputation for focusing on quality of care, limiting their interaction with patients is counterproductive.   

Studies examining nurse practitioners’ effect on care quality bear that out. In one recent study published in the journal Medical Care, nurse practitioners doubled the odds of patients receiving medication management for asthma and increased the odds of receiving recommended screening for cardiovascular disease by 60 percent. 

The Role of Nurse Practitioners in a Shifting Healthcare Landscape  

Healthcare is changing to improve access and reduce costs, with many nurse practitioners taking a proactive role in this shift and starting their own independent practices.  

That means growth in both the access to and quality of care for many Americans, particularly in historically underserved areas, at a time when such care is increasingly urgent.  

According to the AANP, by 2030, experts project a primary care shortfall of more than 120,000 providers, but not evenly distributed. Some communities will have less provider choice and longer waits. Smaller communities will have no access at all. Rural communities are five times more likely to experience  a healthcare shortage, compared to patients living in urban or suburban areas. 

As nurse practitioners continue to meet that need, a long-sought decrease in healthcare costs may also be in reach. Studies throughout the last few years have shown NP care reduces costs. In one recent study published in Health Affairs, costs for nurse practitioners caring for complex patients were about $2,005 lower compared to physician care for similar patients.  

“After adjusting for differences in patients’ medical and social complexity factors, we found meaningfully lower total health care costs for patients of NPs and PAs in a large sample of medically complex VA primary care patients with diabetes, compared to patients of physicians,” the authors of the study said. 

What is Scope of Practice for Nurse Practitioners, and Why It Is Important   

Each state differs on the nurse practitioner scope of practice requirements. Generally, states are split between three main approaches to regulating nurse practitioners: full practice, reduced practice or restricted practice. 

Regulations vary even within each main approach to nurse practitioner scope of practice. The regulations are set by each state’s legislature, governed by the state’s board of nursing or board of medicine, with idiosyncrasies within each state:  

Understanding Full Practice Authority  

Full practice states with full practice authority for nurse practitioners allow all nurse practitioners to evaluate patients; diagnose, order and interpret diagnostic tests; begin and manage treatments, including prescribing medications and controlled substances, under licensure authority of the state’s board of nursing, according to the American Association of Nurse Practitioners

Restricted and Reduced Practice Authority  

Reduced practice states limit at least one element of the nurse practitioner scope of practice, either limiting the settings of one or more elements of care or mandating a career-long regulated collaboration with another provider.  

Restricted practice states limit at least one element of the scope of practice, requiring career-long supervision or management by another provider.   

Full or Restricted Practice Authority By State  

A report from the Association of American Medical Colleges (AAMC) estimates that the U.S. will face a shortage of between 54,100 and 139,000 physicians by 2033. As of May 2021, there are more than 325,000 practicing nurse practitioners in the U.S., a number that’s expected to continue to grow, and will help make up for a shortage of physicians.  

While the need for those nurse practitioners is urgent, their ability to provide the needed care is restricted by the scope of practice. Nursjournal.org provides a list of each state’s nurse practitioner scope of practice regulations and laws.   

Starting Your Own Practice as a Nurse Practitioner  

The promise of nurse practitioner private practices to expand access to the type of primary care nurse practitioners prefer has made the option an increasingly popular career path.  

Knowing how to start a nurse practitioner independent practice the right way will head off pitfalls and accelerate the success of your new venture.     

NP Advantage Can Help  

NP Advantage provides solutions for what you need to set up a nurse practitioner private practice. Partner with us and receive exceptional support from our experienced team of healthcare consultants and data analysts. As partners, we follow a transparent revenue share model based on our initial investment in upfront costs and ongoing relationship, sharing in revenue over time. We’ll set you on the best path for a bright future for your patients, your practice and its success.  

Let’s Improve Patient Care Together

Checklists for Independent Nurse Practitioners

With over 25 years of experience supporting practice launch and growth, we developed the following checklists to guide nurse practitioners. Click the button below to read more.