Expanding Scope of Practice for NPs could save California nearly $2 Billion

Over the next 10 years, California could improve patients access to health care and save $1.8 billion in medical costs if nurse practitioners (NPs) were allowed to practice to the full extent of their education and training, according to a new report from the Bay Area Council Economic Institute funded by the Robert Wood Johnson Foundation and AARP. INQRI grantee Joanne Spetz contributed to the report.

According to the Council, with 3.3 million more Californians having access to health insurance under the Affordable Care Act, allowing NPs to practice independently from doctors is "one of the most effective steps" the state could take to meet the expected increase in demand for primary care providers, FierceHealthcare reports. Expanding scope of practice would increase the number of NPs practicing by 24 percent and would also allow more currently medically underserved communities to gain access to care.

The report reveals that full practice authority for NPs is associated with lower costs for common procedures and does not decrease quality of care: "In states with limited NP practice authority, the average cost for a preventative care visit can be as much as $16 higher than in states with full practice authority. We estimate scope of practice reform in California would save $1.8 billion in the cost of preventative care visits alone over the first ten years."

• The Council's report is available here.
• A statement on the report from the California Association for Nurse Practitioners is available here.

The INQRI-funded study "Scope-Of-Practice Laws For Nurse Practitioners Limit Cost Savings That Can Be Achieved In Retail Clinics” was co-led by Spetz and Stephen Parente.

No Jobs for 43% of Newly Licensed Nurses Responding to California Statewide Survey

A recent survey conducted by the California Institute for Nursing & Health Care (CINHC) has found that forty-three percent of nurses who obtained their RN license within 18 months. With conflicting reports stating that there is a nursing shortage in the United States, this latest poll is rather troubling for new nursing graduates attempting to break into the field. The CINHC survey found that 92% of nurses polled cited that their lack of experience was the primary reason they were unable to obtain a job. This is a rather complex issue with new nursing graduates unable to obtain a job due to lack of experience, and unable to gain experience due to the lack of entry level positions.

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California Court Upholds Rules For Nurses Administering Anesthetics

Yesterday, Bob Egelko, writing for the San Francisco Chronicle, reported that last Thursday the First District Court of Appeals in San Francisco ruled in favor of nurses anesthetists being able to administer anesthesia without a doctor's supervision. This ruling has been heralded by nursing and patient advocacy organizations as a success for rural health where a physician's presence is often difficult to come by. Even though Federal law denies Medicare reimbursements to hospitals that allow nurses to give anesthesia without direct supervision, California is one of 16 states to opt out of this requirement after consulting with their state medical board. This court ruling aligns with recommendations made in the IOM's Initiative on the Future of Nursing committee's report: "The Future of Nursing: Leading Change, Advancing Health" by allowing nurse anesthetists to serve patients without physician oversight, California has improved rural access to numerous health services that require anesthesia, in addition to providing safe, cost-effective care by trained professionals.

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Bill Would Allow Non-Doctors To Perform Abortions In California

Last week, California state senator, Christine Kehoe (D-San Diego), introduced legislation that would allow licensed nurse practitioners, physician assistants and nurse midwives to perform aspiration abortions, which is a non-surgical procedure most often used to terminate a pregnancy in the first trimester. Currently, only four other states allow for non-physicians to conduct non-surgical abortions and Sen. Kehoe argues that this expansion would, "give many California women access to earlier, safer procedures in the first trimester of their pregnancy".

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