September 26, 2016
The Citizens Research Council of Michigan has examined the ways in which Advanced Practice Registered Nurses (APRNs) can help solve many of Michigan’s health care issues, namely accessible and affordable healthcare. The new report, Expanding Scope of Practice to Address Healthcare Costs and the Physician Shortage in Michigan, examines the key issues in expanding APRN practice to encompass a broader range of tasks that they are educated and trained to perform. In addition to benefits and considerations in expanding scope of practice, the report outlines the steps that policymakers could take if they choose to alter the laws that restrict APRN practice.
States possess the authority to determine the scope in which APRNs can legally practice. In Michigan, APRNs are allowing to treat patients, but cannot diagnose conditions or prescribe medication without physician oversight. Over one-third of states allow APRNs to diagnose and treat patients and prescribe medications without physician oversight or involvement. Michigan has the most restrictive practice laws for APRNs in the Great Lakes region, where several neighboring states have recently amended their laws to allow greater practice authority.
“Changing APRN scope of practice requirements to include tasks with which they are educated and trained to perform is a remedial action that has repeatedly been proposed to healthcare issues that the Citizens Research Council has examined,” says CRC President Eric Lupher. “Namely, evidence supports improvements to both healthcare costs and patient access when APRNs are permitted to practice without physician oversight.”
“APRNs are already a significant provider of health care in Michigan. Permitting them to practice to the full extent of their education, training, and licensure could provide an evidence-based way to address physician shortages in the state and temper healthcare cost growth,” says CRC President Eric Lupher.
If state policymakers wish to expand APRN practice, they would need to update the Public Health Code to include diagnosis in the definition of tasks provided by an APRN, create statutory licensure, and prescriptive authority. Other statutes could be updated that would allow APRNs to independently own and operate a practice and encourage or require health insurers to pay APRNs directly for their services.
The paper is available at no cost on the Citizens Research Council’s website, www.crcmich.org.