Cover: The Impact of Full Practice Authority for Nurse Practitioners and Other Advanced Practice Registered Nurses in Ohio

The Impact of Full Practice Authority for Nurse Practitioners and Other Advanced Practice Registered Nurses in Ohio

Published Jan 28, 2015

by Grant R. Martsolf, David I. Auerbach, Aziza Arifkhanova

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Research Questions

  1. What effect do SOP laws for APRNs have on health-care access, quality, and costs?
  2. According to estimates from the published literature, what effect might relaxing SOP laws have on health-care access, quality, and costs, specifically in the state of Ohio?

Advanced practice registered nurses (APRNs) make up the fastest-growing segment of the primary-care professional workforce in the United States. States are considering expanding scope-of-practice (SOP) laws for these APRNs as a potential approach to improve access to care, maintain or enhance care quality, and decrease overall health-care costs. Previous studies have demonstrated that APRNs deliver care that is of equal quality to the care provided by their physician counterparts. As part of an extensive literature review, RAND Corporation researchers identified three high-quality studies addressing the impact that expanded SOP laws could have on health-care access, quality, and costs. Informed by this review of literature, the authors describe the potential effect of removing SOP restrictions for APRNs in the state of Ohio. Their review of the literature and effect estimates demonstrate that granting APRNs full practice authority would likely increase access to health-care services for Ohioans, with possible increases in quality and no clear increase in costs.

Key Findings

Access to Care Would Improve

  • The improvement in the numbers of adults receiving routine checkups within one to two years could range from roughly 158,557 to 515,573. As many as an additional 1.5 million Ohio residents would potentially report better access to care.

Impacts on Quality and Outcomes of Care Are Uncertain

  • Removing restrictive scope-of-practice (SOP) laws for nurse practitioners could lead to around 70,000 fewer ambulatory care--sensitive emergency visits in Ohio, and as many as 1.2 million patients could potentially report improved care experiences.

After SOP Laws Change, Prices for Certain Types of Visits Could Go Down

  • The effect on costs is unclear for the state of Ohio. The price of well-child visits and prevalence of ambulatory-sensitive emergency-department visits could drop. Conversely, overall utilization would likely increase, given improved access to care.

The work reported here was conducted in RAND Health, a division of the RAND Corporation.

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