research (Selected works)
Abstract
Policymakers aiming to increase access to health care while simultaneously keeping costs low and quality high are considering expanding the practice authority and prescriptive authority of nurse practitioners in order to address primary care shortages. While we know this increases access, some researchers argue that the expansion of job autonomy of nurse practitioners can compromise the quality and safety of rendered medical services. This paper investigates quality and safety outcomes in prescribing behaviors of nurse practitioners who have prescribed opioids for Medicare Part D beneficiaries using a unique source of policy variation, nurse practitioners with the ability to prescribe medication who move to either states with or without physician supervision. We find that scope of practice expansions do not compromise quality and safety in terms of potential abuse or misuse of prescriptive authority.
Abstract
Public safety is often used as an argument against expanding scope of practice (SOP) for nurse practitioners, despite the benefit of filling unmet health care demand. As a response to the COVID-19 Pandemic, some states expanded SOP for nurse practitioners to accommodate the unprecedented healthcare challenge. We analyze the effect of the expansion of SOP on daily COVID-19-related mortality, exploiting the quasi-random state policy changes at the beginning of the COVID-19 pandemic. Checking different model specifications, we do not find evidence that expanding SOP for nurse practitioners during the pandemic causes adverse effects on patients measured by COVID-19 mortality.
testimony
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educational one-pagers
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