Impact of state scope-of-practice laws on nurse practitioner-provided home visits

Zainab Toteh Osakwe, Ryung S. Kim, Chinedu U. Obioha, Jennel C. Osborne, Nafin Harun, Rose Saint Fleur-Calixte

Research output: Contribution to journalArticlepeer-review

Abstract

Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits. The PUF file was merged with the 2017 American Community Survey to assess area-level median income. Over 4.4 million home visits were provided to 1.6 million Medicare beneficiaries. NPs represented the largest share of providers (47.5%). In states with restricted SOP laws, compared to NPs, physicians and physician assistants had higher odds of providing HBPC. In states with reduced SOP laws, compared to NPs, physicians and PAs had decreased odds of providing HBPC. Our study provides evidence that SOP restrictions are associated with decreased utilization of NP-provided HBPC.

Original languageEnglish (US)
Pages (from-to)674-680
Number of pages7
JournalGeriatric Nursing
Volume42
Issue number3
DOIs
StatePublished - May 1 2021

Keywords

  • Home visits
  • NP-scope of practice
  • Nurse practitioners
  • Rural health

ASJC Scopus subject areas

  • Gerontology

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