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A Policy Analysis of Legally Required Supervision of Nurse Practitioners and Other Health Professionals.

Authors
  • Ritter, Ashley Z1
  • Bowles, Kathryn H2
  • O'Sullivan, Ann L2
  • Carthon, Margo Brooks2
  • Fairman, Julie A2
  • 1 University of Pennsylvania School of Nursing, Philadelphia, PA. Electronic address: [email protected]
  • 2 University of Pennsylvania School of Nursing, Philadelphia, PA.
Type
Published Article
Journal
Nursing outlook
Publication Date
Nov 01, 2018
Volume
66
Issue
6
Pages
551–559
Identifiers
DOI: 10.1016/j.outlook.2018.05.004
PMID: 30122248
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The use of legally required supervision occurs across health professionals who provide similar services. Legally required supervision has the potential to disrupt the production of high-quality, cost-efficient, accessible health services across disciplines. This paper examines the effects of nurse practitioner collaborative practice agreements and similar models of health professional regulation, defined as legally required supervision, on the cost and delivery of health services. A policy analysis examines empirical, policy, and law literature between two health professionals providing a similar service. Analysis includes literature on dental hygienists, dentists, certified registered nurse anesthetists, midwives, nurse practitioners, physicians, and pharmacists. A framework for legally required supervision across health professionals is presented. Antecedents of legally required supervision include occupational licensure, reimbursement policy, and institutional policy. Legally required supervision inhibits provider entry to practice and the production of health services by supervised providers. The cost of care increases under legally required supervision. Costs are measured by wages for providers and the price of services for patients. This paper and proposed framework summarize the antecedents and consequences of legally required supervision. Discipline-specific antecedents and provider characteristics must be considered when calculating the full effect of legally required supervision on the delivery and cost of health services. Copyright © 2018. Published by Elsevier Inc.

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