The Financial And Cost Accounting Implications Of The Increased Role Of Advanced Nurse Practitioners In U.S. Healthcare

Abstract

On March 23, 2010, the Affordable Care Act became law. The need for healthcare reform was prompted by an imperative to reduce the relentless increase in spending on medical care in the United States. One approach to examining and solving the problem of escalating costs is to focus on applying proven principles of evidence-based practice and cost-effectiveness practices to find the least-expensive way to ensure clinical services of acceptable quality without sacrificing patient satisfaction. Advanced practice registered nurses (APRNs) have positioned themselves to serve an integral role in national health care reform. A successful transformation of the nation's health system will require utilization of all clinicians, including highly qualified APRNs, to provide cost- effective, accessible, patient-centered care. There is extensive, consistent evidence that nurse practitioners (NPs) provide care of equal or better quality at lower cost than comparable services provided by other qualified health professionals. However, current policies in many states prevent NPs from practicing within their full, legally defined scopes of practice. The Office of Technology Assessment's conclusions noted in 1981 that APRNs can be substituted for physicians in a significant portion of medical services with at least similar outcomes. Since then, numerous studies have supported that the care provided is equal to those provided by physicians for services within the overlapping scopes of licensed practice. This paper combines economic analysis with review of literature on health care reform initiatives to explore how the goals of healthcare reform can be accomplished by advanced nurse practitioners to provide their wide range of services directly to patients in a variety of clinical settings.