Nurse Practitioners Poised to Take the Lead in Primary Health Care
April 20th, 2010
By Pamela Cipriano. Access to care from Nurse Practitioners got two boosts in recent weeks. The health insurance reform legislation (Patient Protection and Affordable Care Act, Public Law 111-148) contains important provisions that will address payment and recognition of NP services in medical homes and nurse managed health centers. (Refer to Lisa Korin’s blog 4/16 on “The Patient Centered Medical Home Model: A Way to CostiEffectively Improve Quality of Care”) Original plans for medical home models had been stalled, and included payment only for physicians; the new law recognizes nurse practitioners as leaders of primary care practices and makes them eligible for reimbursement. Nurse practitioners are also key providers and leaders of Nurse Managed Health Centers (NMHC). Reform legislation has made available a new $50 million grant program to help innovative safety net providers. NMHCs provide a full spectrum of primary care including health promotion and disease prevention to under-served populations, primarily in areas where the supply of primary care physicians is not adequate.
Another development, which may be below most people’s radar screens is a timely report from the Macy Foundation. Dr. Linda Cronenwett, Professor and Dean Emeritus of the School of Nursing, University of North Carolina, Chapel Hill, and Dr. Victor J. Dzau, James B. Duke Professor of Medicine, Chancellor of Health Affairs of Duke University, and CEO of Duke Health System were co-chairs of a conference held in January of this year addressing, “Who will provide primary care, and how will they be trained?” While hailing some of the newest developments in team care and use of electronic technologies, the group called for fundamental changes in the education of primary care providers as well as reformed payment structures and incentives that encourage more providers to engage in primary care to meet health needs of individuals and communities. The conference conclusions are rich in actions to address a future workforce, new interprofessional education models, strong innovative leadership, and removal of barriers that hinder nurse practitioners and physician’s assistants from being primary care providers. A full report of conference proceedings is due out later this year; the co-chair conference summary can be found at: http://www.josiahmacyfoundation.org/documents/jmf_ChairSumConf_Jan2010.pdf
A Yahoo! news report last week highlights all these developments, underscoring the debate around NPs providing primary care, but highlighting the patient satisfaction and quality outcomes we know are associated with care by NPs. http://news.yahoo.com/s/ap/20100414/ap_on_he_me/us_med_dr_nurse
UPDATE:
On our Facebook Fan Page, Susan Rinkus Farrell shared the following great video about Nurse Practitioners:
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