Improving Value

Provider Scope of Practice

Provider scope of practice laws define the range of services that various types of clinicians are authorized to provide. As of 2019, the majority of states have passed legislation expanding non-physician providers' scope of practice to expand access to care in communities with shortages of physicians. The rationale is that certain providers (like Nurse Practitioners and physician assistants) can skillfully perform routine services, allowing physicians to focus on tasks that require a higher level of clinical expertise. 

Despite pushback from physician organizations, studies show that non-physician providers can, under the right circumstances, provide an equivalent level of care as physicians, at a lower cost.¹ However, research has also identified a need for greater educational and licensure standards for providers with expanded scopes of practice, and improved data collection in order to increase accountability and ensure quality of care.² 

 

Notes

1. Morgan, Perri A., et al., "Impact of Physicians, Nurse Practicioners, and Physician Assistants on Utilization and Costs for Complex Patients," Health Affairs, Vol. 38, No. 6 (June 2019). 

2. National Conference of State Legislatures, "Meeting the Primary Care Needs of Rural America: Examining the Role of Non-Physician Providers: The Research."

More on this Topic

• Scope of Practice Policy (Accessed April 29, 2020). 
• Health Affairs: Impact of Physicians, Nurse Practicioners, and Physician Assistants on Utilization and Costs for Complex Patients (June 2019). 
• Health Affairs Blog: Home Health Care Providers Struggle with State Laws and Medicare Rules as Demand Rises (June 2019). 
• Health Affairs Blog: Rural and Nonrural Primary Care Physician Practices Increasingly Rely on Nurse Practicioners (June 2018). 
• National Conference of State Legislatures: Scope of Practice Archive Database (September 1, 2017).