Study: Limiting NPs' scope of practice leads to higher costs

NEW YORK — Shedding more light on the important role that retail-based health clinics — and the nurse practitioners who work in them — play in the U.S. healthcare system, a new study suggests that eliminating restrictions on nurse practitioners' scope of practice could have a “large impact” on the cost-savings.

The study, titled “Practitioners Limit Cost Savings That Can Be Achieved in Retail Clinics,” was published in the November issue of Health Affairs.

“Using multistate insurance claims data from 2004–2007, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations,” researchers stated.

The bottom line: Researchers found that visits to retail clinics were associated with lower costs per episode, compared with episodes of care that did not begin with a retail clinic visit. Furthermore, the costs were even lower when NPs practiced independently.

More specifically, an article by FierceHealthcare on the study reports that, according to researchers, in states where physicians oversaw nurse practitioners, costs averaged $543, versus $484 in states where nurse practitioners practiced independently. Costs averaged $509 in states where nurse practitioners had independence in practice and prescribing.

The article also states that according to researchers, if retail-based clinic visits make up for 10% of all outpatient primary care visits by 2015, national cost savings would be $2.2 billion. If nurse practitioners in all 50 states practiced independently, that would add on an additional $810 million. That savings could grow even more — by $472 million — if nurse practitioners could prescribe on their own too.

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