The Rise of the Autonomous Nurse Practitioner Due to the Affordable Care Act

The Rise of the Autonomous Nurse Practitioner Due to the Affordable Care Act

The rise of the autonomous nurse practicioner due to the affordable care act

The Affordable Care Act opened a window of opportunity for NPs to apply for practice autonomy. Instead of the five years and 10,000 hours that nurse practitioners need to have before they could apply for it, an executive order cut it to two years and 5,000 hours.

Having autonomy means that nurse practitioners have the authority to provide medical services in a manner that is distinct from the physician. It also allows them to work on their own initiative to manage clinical duties and increase patient satisfaction scores.

1. Increasing Access to Care

The ACA brought about a sweeping increase in access to care, especially for marginalized groups that were uninsured before the law was passed. These include women, children, people with disabilities and the elderly.

The Affordable Care Act also requires that insurance companies cover preventive services like well-woman visits without cost sharing. In addition, Medicaid and CHIP have expanded coverage in many states.

However, these efforts have not yet led to universal coverage. Millions of Americans remain uninsured or underinsured, particularly in the poorest and most vulnerable.

A number of states are considering a new option to address this problem: allowing nurse practitioners to practice independently. These laws are designed to increase the supply of primary care providers, particularly in rural areas.

2. Increasing Efficiency

The affordable care act has put consumer rights and protections in place to ensure that your health care dollars are spent wisely. The law also provides tax credits and marketplaces that help lower your premiums.

This is especially important for patients who have a high deductible or who don’t have insurance. Moreover, thanks to the ACA’s 80/20 rule, insurance companies must spend at least eighty percent of your premiums on medical care and quality improvement rather than advertising, overhead and bonuses for executives.

As a result, some states have embraced the concept of the autonomous nurse practitioner. New York, for example, has a law that allows NPs who have completed at least 3,600 hours of clinical experience to practice independently without the need for a doctor’s supervision.

3. Increasing Value

The affordable care act created a new environment for nurse practitioners to become full partners with physicians and other health professionals. This expanded the scope of practice for APRNs, increasing their ability to provide comprehensive care and decreasing disparities (Pappas & Welton, 2015).

Autonomous NPs are fully authorized to see and diagnose patients, prescribe medications, and make referrals, according to state law. In Wyoming, NPs also can sign death certificates and disability placard forms without a physician’s supervision.

But that’s a small part of the story. Virginia’s strict standards — a significant outlier among the more relaxed models in the country — have made it difficult for NPs to get autonomous practice.

Those restrictions have caused many NPs to leave the commonwealth, Reid said, leading to a strained workforce. But if more NPs were to garner autonomy, she said, they could help bridge gaps in care, especially in the state’s 124 “health professional shortage areas,” where nearly two million people live in regions where NPs are scarce.

4. Increasing Flexibility

As the affordable care act continues to grow, nurse practitioners are stepping up to meet the demand for healthcare services. They are lowering healthcare costs, reducing emergency room visits and hospital stays, and providing more patient education.

For many, this means being able to work in a flexible way. Solutions like Mercy Works on Demand offer a gig-based schedule that can be tailored to nurses’ needs.

NPs who are practicing autonomously are gaining trust in their abilities to take on new tasks and demonstrate high standards of care. They are also bringing back joy to nursing by working in a way that is meaningful for them.

The NPs in this study shared that autonomy is about having the right knowledge, skills and information to make decisions safely and based on clinical judgement. They also reflected on the need for up-to-date knowledge and research in order to practice safely. During the interviews, they described a variety of situations where they needed to be able to make on-the-spot decisions without consulting with a physician first.

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About the Author: Raymond Donovan