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Affordable Care Act and Nurse Practitioner

Susan A Chapman, Bethany J Phoenix, Talia E Hahn, Deborah C Strod
INTRODUCTION: Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems...
June 2018: American Journal of Preventive Medicine
Heather M Brom, Pamela J Salsberry, Margaret Clark Graham
BACKGROUND AND PURPOSE: Since development of the nurse practitioner (NP) role, NPs have been advocating for policy allowing them to practice to the full extent of their training. The aim of this research was to determine whether passage of the Affordable Care Act (ACA) had an impact on expansion of NPs' scope of practice. METHODS: This was a retrospective descriptive study of NPs' scope of practice legislation from 1994 to 2016 using regulatory theory. Data sources included annual reports on NP legislation and state-level legislative and media coverage...
March 2018: Journal of the American Association of Nurse Practitioners
Adam I Biener, Samuel H Zuvekas, Steven C Hill
OBJECTIVE: To quantify the effect of Medicaid expansions on office-based care among the newly eligible. DATA SOURCE: 2008-2014 Medical Expenditure Panel Survey. STUDY DESIGN: The main sample is adults age 26-64 with incomes ≤138% of poverty who were not eligible for Medicaid prior to the Affordable Care Act. For this population, difference-in-differences linear probability models compare utilization between expansion and nonexpansion states and between 2008-2013 and 2014...
October 20, 2017: Health Services Research
Danielle Mazza, Deborah Bateson, Meredith Frearson, Philip Goldstone, Gab Kovacs, Rod Baber
BACKGROUND: Australia's abortion rates are among the highest in the developed world. Efficacy of the most commonly used form of contraception (oral contraceptives and condoms) relies on regular user compliance. Long-acting reversible contraception (LARC) virtually eradicates contraceptive failure as it is not user-dependent; however, its uptake has been low. AIM: To provide an overview of barriers to LARC use in Australia and potential strategies to overcome these barriers...
April 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Andréa Sonenberg, Hillary J Knepper
BACKGROUND: Health disparities persist among morbidity and mortality rates in the United States. Contributing significantly to these disparities are the ability to pay for health care (largely, access to health insurance) and access to, and capacity of, the primary care health workforce. PURPOSE: This article examines key determinants of health (DOH) including demographics, public and regulatory policies, health workforce capacity, and primary health outcomes of four states of the United States...
March 2017: Nursing Outlook
Andrea Collins, Amy Broeseker, Jill Cunningham, Cyndi Cortes, Jennifer Beall, Amy Bigham, Jongwha Chang
Interprofessional education (IPE) continues to gain traction worldwide. Challenges integrating IPE into health profession programmes include finding convenient times, meeting spaces, and level-appropriate assignments for each profession. This article describes the implementation of a 21-month prospective cohort study pilot programme for the Master of Science in nursing family nurse practitioner (FNP) and doctor of pharmacy (PharmD) students at a private university in the United States. This IPE experience utilised a blended approach for the learning activities; these students had initial and final sessions where they met face-to-face, with asynchronous online activities between these two sessions...
March 2017: Journal of Interprofessional Care
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
Dennis A Taylor, Britney S Broyhill, Allison M Burris, Mary Ann Wilcox
The healthcare provider landscape is rapidly changing. Given the imminent retirement of baby boomer physicians, implementation of the Affordable Care Act, and the increased utilization of health care services by an ever-aging population, the supply of providers cannot keep pace with the demand for services. This has led to an increased utilization of advanced clinical practitioners (ACPs). This article shows how one large highly-matrixed health care system approached identifying this workforce, and how thought leaders worked collaboratively with physicians, administrators, and ACPs to meet a growing demand for providers...
January 2017: Nursing Administration Quarterly
Elena Kraus, James M DuBois
BACKGROUND: The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate that changes to the laws governing NP practice will engender acrimony between practicing physicians and NPs. However, we lack empirical, descriptive data on how practicing professionals view NP independence in primary care...
March 2017: Journal of General Internal Medicine
Mindy B Tinkle, Beth B Tigges, Blake Boursaw, Deborah R McFarlane
OBJECTIVE: To assess the adherence of women's health providers in New Mexico to the Women's Preventive Services Guidelines and to examine how providers' knowledge, attitudes, and external barriers are associated with adherence. DESIGN: Cross-sectional, descriptive survey. SETTING: New Mexico. PARTICIPANTS: Women's health providers in New Mexico, including nurse practitioners, certified nurse-midwives, and family practice and obstetrician-gynecologist physicians...
November 2016: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Renuka Tipirneni, Karin V Rhodes, Rodney A Hayward, Richard L Lichtenstein, HwaJung Choi, Elyse N Reamer, Matthew M Davis
OBJECTIVES: With insurance enrollment greater than expected under the Affordable Care Act, uncertainty about the availability and timeliness of healthcare services for newly insured individuals has increased. We examined primary care appointment availability and wait times for new Medicaid and privately insured patients before and after Medicaid expansion in Michigan. STUDY DESIGN: Simulated patient ("secret shopper") study. METHODS: Extended follow-up of a previously reported simulated patient ("secret shopper") study assessing accessibility of routine new patient appointments in a stratified proportionate random sample of Michigan primary care practices before versus 4, 8, and 12 months after Medicaid expansion...
June 2016: American Journal of Managed Care
Lynda Jarrell
The Patient Protection and Affordable Care Act of 2010 and the aging U.S. population have created a substantial shortage of primary care providers. Nurse practitioners (NPs) provide a cost-effective solution to meet this growing demand; however, the professional development and mentoring needs of NPs have not been clearly defined. This quantitative descriptive study assessed the professional development and mentorship needs of NPs as a first step toward development of effective programs to meet those needs.
January 2016: Journal for Nurses in Professional Development
Salim S Virani, Thomas M Maddox, Paul S Chan, Fengming Tang, Julia M Akeroyd, Samantha A Risch, William J Oetgen, Anita Deswal, Biykem Bozkurt, Christie M Ballantyne, Laura A Petersen
BACKGROUND: The current number of physicians will not be sufficient to accommodate 30 to 40 million Americans expected to secure health coverage with Affordable Care Act implementation. One proposed solution is to use advanced practice providers (APPs) (nurse practitioners and physician assistants). OBJECTIVES: This study sought to determine whether there were clinically meaningful differences in the quality of care delivered by APPs versus physicians in a national sample of cardiology practices...
October 20, 2015: Journal of the American College of Cardiology
J Margo Brooks Carthon, Hilary Barnes, Danielle Altares Sarik
Although most nurse practitioners (NPs) are aware of state-level regulations that influence practice, many are unaware of the ways that federal policies affect NP workforce supply and the delivery of primary care. In this investigation we provide an overview of federal initiatives enacted through the Patient Protection and Affordable Care Act that impact the NP workforce. We explore how the law supports NP workforce supply and settings in which NPs provide care. We then describe challenges that may prevent full utilization of the NP workforce...
May 2015: Journal for Nurse Practitioners: JNP
Dianne Aroh, Joan Colella, Claudia Douglas, Ashley Eddings
The Affordable Care Act (ACA) (2010) launch of Medicare Value-Based Purchasing (VBP) has become the platform for buyers of health care to hold health care providers accountable for demonstrating high-quality, cost-effective care for Medicare recipients across the trajectory of care practitioners and settings (Gardner, 2013; VanLare & Conway, 2012). The Centers for Medicare and Medicaid Services (CMS), authorized under the ACA, specified quality measures that will best advance the National Quality strategic objectives and build upon the Hospital Inpatient Quality Reporting infrastructure (U...
March 2015: Urologic Nursing
(no author information available yet)
A new survey from The Kaiser Family Foundation and The Commonwealth Fund asked primary care providers--physicians, nurse practitioners, and physician assistants--about their views of and experiences with the Affordable Care Act (ACA) and other changes in health care delivery and payment, as well as their thoughts on the future of primary care. In this first brief based on the survey, many providers reported seeing an increased number of patients since the coverage expansions went into effect, but not an accompanying compromise in quality of care...
June 2015: Issue Brief of the Commonwealth Fund
Daniel H Solomon, Liana Fraenkel, Bing Lu, Erika Brown, Peter Tsao, Elena Losina, Jeffrey N Katz, Asaf Bitton
OBJECTIVE: The Affordable Care Act proposes wider use of nurse practitioners (NPs) and physician assistants (PAs), but little is known about outcomes of care provided by them in medical specialties. We compared the outcomes of care for patients with rheumatoid arthritis (RA) seen in practices with NPs or PAs and rheumatologists versus practices with rheumatologists only. METHODS: We enrolled 7 rheumatology practices in the US (4 with NPs or PAs and 3 without). RA disease activity (categorized as in remission, low, moderate, or high, using standardized measures) was abstracted from medical records from the most recent 2 years...
December 2015: Arthritis Care & Research
Michelle Proser, Tyler Bysshe, Donald Weaver, Ronald Yee
In response to increased demand for primary care services under the Affordable Care Act, the national network of community health centers (CHCs) will play an increasingly prominent role. CHCs have a broad staffing model that includes extensive use of physician assistants (PAs), nurse practitioners (NPs), and certified nurse midwives (CNMs). Between 2007 and 2012, the number of PAs, NPs, and CNMs at CHCs increased by 61%, compared with 31% for physicians. However, several policy and payment issues jeopardize CHCs' ability to expand their workforce and meet the current and rising demand for care...
April 2015: JAAPA: Official Journal of the American Academy of Physician Assistants
Aastha N Chandak, Fausto R Loberiza, Marlene Deras, James O Armitage, Julie M Vose, Jim P Stimpson
PURPOSE: This study describes the supply of cancer care providers-physicians, nurse practitioners (NPs), and physician assistants (PAs)-in Nebraska and analyzes changes in the supply over a 5-year period. METHOD: We used workforce survey data for the years 2008 to 2012 from the Health Professions Tracking Service to analyze the cancer care workforce supply in the state of Nebraska. The supply of cancer care providers was analyzed over the 5-year period on the basis of age, sex, specialty, and practice location; distribution of work hours for cancer care physicians was analyzed for 2012...
January 2015: Journal of Oncology Practice
Peter I Buerhaus, Catherine M DesRoches, Robert Dittus, Karen Donelan
BACKGROUND: Projections of physician shortages, an aging population, and insurance expansions have increased interest in expanding the number of primary care nurse practitioners (PCNPs) in the United States. Although information about the number and distribution of nurse practitioners is known, there is little information about the practice characteristics of PCNPs. The purpose of this study was to identify demographic and practice characteristics of PCNPs and compare these characteristics with primary care physicians (PCMDs)...
March 2015: Nursing Outlook
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