Full Practice Authority for Nurse Practitioners

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. Revisiting outdated state practice laws, and considering Full Practice Authority (FPA) for nurse practitioners (NP), is needed for improving access to care while creating greater flexibility for development of patient-centered health care homes and other emerging models of care delivery. Currently, 21 states and the District of Columbia have adopted FPA for NPs, with 15 more states planning legislation in 2016. Allowing FPA and Prescriptive Authority (PA) enables NPs to become more efficient and effective patient care team members. However, physician resistance to FPA and PA presents barriers to implementation.