NR 506 NP Week 1 Discussion

NR 506 NP Week 1 Discussion

Student Name

Chamberlain University

NR-506: Healthcare Policy

Prof. Name:

Date

Barriers to Advanced Practice Nurse (APN) Practice: State and National Perspectives

Practice Barriers for APNs on the State and National Level

Advanced Practice Nurses (APNs), particularly Family Nurse Practitioners (FNPs), face various barriers at both the state and national levels. These obstacles include restrictions on licensure, prescriptive authority, and reimbursement policies. Each state has different regulations that impact APNs’ scope of practice. In Kentucky, FNPs can practice independently but require a collaborative agreement with a physician to prescribe controlled substances (Kentucky Board of Nursing, 2020). In contrast, other states impose more restrictive regulations, further limiting APNs’ ability to provide care autonomously. Additionally, at the national level, APNs often receive lower reimbursement rates from Medicare and private insurers than physicians. Perloff, DesRoches, and Buerhaus (2016) highlight that nurse practitioners are reimbursed approximately 29% less than physicians for the same procedures, posing a significant financial barrier to their practice.

Competition Hindering APN Independence

APNs face competition from both physicians and physician assistants (PAs), which can limit their ability to practice independently. Many healthcare facilities prioritize hiring physicians due to the misconception that they provide superior care compared to nurse practitioners. This belief is reflected in patient preferences, where individuals may request to see a “real doctor” rather than an FNP, as observed in various clinical settings. Additionally, PAs often apply for the same mid-level positions as FNPs, further intensifying competition in the job market. In states such as Wyoming, the introduction of emergency nurse practitioner certification faced significant resistance due to doubts about FNPs’ competencies in emergency care (Davis, 2019). Instead of advocating for nurse practitioners, some hospitals replaced them with physicians or PAs, reinforcing existing biases and restricting APNs’ practice opportunities.

Legislative Influence and Interest Groups in APN Policy

Key lawmakers at the state level, particularly in Kentucky, play a crucial role in shaping healthcare policies that affect APNs. The executive branch, led by Governor Andy Beshear, oversees the Cabinet for Health and Family Services, which advocates for access to healthcare programs (Commonwealth of Kentucky, 2020). The legislative branch, which includes non-partisan committees responsible for Kentucky Medicaid, also influences laws governing APN practice. Interest groups such as the Kentucky Nurses Association (KNA) and the American Association of Nurse Practitioners (AANP) actively advocate for policy changes at both state and national levels. These organizations promote full practice authority, improved reimbursement policies, and enhanced prescriptive rights for APNs (Kopanos, 2020).

Strategies for Influencing Policy Change

APNs can influence policy changes through advocacy, education, and legislative engagement. Educating the public about the role of nurse practitioners is essential in dispelling misconceptions about their competencies. Community support can drive legislative changes by demonstrating the positive impact of APNs on healthcare access. Additionally, APNs can collaborate with interest groups to push for policy reforms that expand their scope of practice. Engaging with state legislative and executive branches through lobbying efforts and professional organizations can further enhance APNs’ influence in shaping healthcare policies. As the physician shortage continues to grow, expanding APN practice privileges can help address the increasing demand for healthcare services (Corso, Dorrance, & LaRochelle, 2018). Through continuous advocacy and education, APNs can secure more autonomy in their practice and contribute to improving healthcare accessibility.

Table: Barriers, Competition, and Policy Influence on APN Practice

References

Commonwealth of Kentucky. (2020). General government. Retrieved from https://transparency.ky.gov/accountability/gengov/Pages/default.aspx

Corso, K. A., Dorrance, K. A., & LaRochelle, J. (2018). The physician shortage: A red herring in American health care reform. Military Medicine, 183, 220–224.

Davis, W. D. (2019). Moving the emergency nurse practitioner specialty from resistance to acceptance: The Wyoming experience. Advanced Emergency Nursing Journal, 41(4), 279.

Kentucky Board of Nursing. (2020). APRN prescriptive authority. Retrieved from https://kbn.ky.gov/practice/Pages/APRNPresAuth.aspx

NR 506 NP Week 1 Discussion

Kopanos, T. (2020). AANP forum. Journal for Nurse Practitioners, 16(2), A13–A15.

Perloff, J., DesRoches, C. M., & Buerhaus, P. (2016). Comparing the cost of care provided to Medicare beneficiaries assigned to primary care nurse practitioners and physicians. Health Services Research, 51(4), 1407–1423.