Impact of state scope-of-practice laws on nurse practitioner-provided home visits

Zainab Toteh Osakwe; Ryung S. Kim; Chinedu U. Obioha; Jennel C. Osborne; Nafin Harun; Rose Saint Fleur-Calixte

doi:10.1016/j.gerinurse.2021.03.002

Impact of state scope-of-practice laws on nurse practitioner-provided home visits

Zainab Toteh Osakwe, Ryung S. Kim, Chinedu U. Obioha, Jennel C. Osborne, Nafin Harun, Rose Saint Fleur-Calixte

Epidemiology & Population Health

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits. The PUF file was merged with the 2017 American Community Survey to assess area-level median income. Over 4.4 million home visits were provided to 1.6 million Medicare beneficiaries. NPs represented the largest share of providers (47.5%). In states with restricted SOP laws, compared to NPs, physicians and physician assistants had higher odds of providing HBPC. In states with reduced SOP laws, compared to NPs, physicians and PAs had decreased odds of providing HBPC. Our study provides evidence that SOP restrictions are associated with decreased utilization of NP-provided HBPC.

Original language	English (US)
Pages (from-to)	674-680
Number of pages	7
Journal	Geriatric Nursing
Volume	42
Issue number	3
DOIs	https://doi.org/10.1016/j.gerinurse.2021.03.002
State	Published - May 1 2021

Keywords

Home visits
NP-scope of practice
Nurse practitioners
Rural health

ASJC Scopus subject areas

Gerontology

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10.1016/j.gerinurse.2021.03.002

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title = "Impact of state scope-of-practice laws on nurse practitioner-provided home visits",

abstract = "Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits. The PUF file was merged with the 2017 American Community Survey to assess area-level median income. Over 4.4 million home visits were provided to 1.6 million Medicare beneficiaries. NPs represented the largest share of providers (47.5%). In states with restricted SOP laws, compared to NPs, physicians and physician assistants had higher odds of providing HBPC. In states with reduced SOP laws, compared to NPs, physicians and PAs had decreased odds of providing HBPC. Our study provides evidence that SOP restrictions are associated with decreased utilization of NP-provided HBPC.",

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AU - Osakwe, Zainab Toteh

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AU - Obioha, Chinedu U.

AU - Osborne, Jennel C.

AU - Harun, Nafin

AU - Saint Fleur-Calixte, Rose

PY - 2021/5/1

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AB - Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits. The PUF file was merged with the 2017 American Community Survey to assess area-level median income. Over 4.4 million home visits were provided to 1.6 million Medicare beneficiaries. NPs represented the largest share of providers (47.5%). In states with restricted SOP laws, compared to NPs, physicians and physician assistants had higher odds of providing HBPC. In states with reduced SOP laws, compared to NPs, physicians and PAs had decreased odds of providing HBPC. Our study provides evidence that SOP restrictions are associated with decreased utilization of NP-provided HBPC.

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Impact of state scope-of-practice laws on nurse practitioner-provided home visits

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

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