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Highlights of the New HHS Report on Reforming Healthcare

December 27, 2018

Highlights of the New HHS Report on Reforming Healthcare

By Debra Wood, contributor

The U.S. Department of Health and Human Services (HHS) and other federal agencies drafted a report for the president about how to reform the country’s healthcare system through choice and competition. The Departments of the Treasury and Labor, the Federal Trade Commission and the White House collaborated on the report.

Reforming America’s Healthcare System Through Choice and Competition,” released on December 3, 2018, focuses on four areas:

  • Healthcare workforce and labor markets
  • Provider markets
  • Insurance markets, and
  • Consumer-driven healthcare

Among the HHS report recommendations are to broaden providers’ scope of practice to the top of providers’ licenses and increasing mobility, with compact licenses and telehealth. The authors expect these measures for reforming healthcare will encourage innovation and enable providers to meet patients’ needs more easily.

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Scope of practice

More than 248,000 nurse practitioners are licensed in the United States, according to American Association of Nurse Practitioners (AANP), and 106,200 physician assistants, according to the Bureau of Labor Statistics.

Broadening nurse practitioners’ and physician assistants’ scope of practice has been and remains a priority of the AANP and the AAPA, the physician assistant organization.

“The report acknowledges an ever-growing body of works and research showing patients stand to benefit greatly from expanded access to NP-provided care,” said Joyce M. Knestrick, PhD, APRN, CFNP, FAANP, president of the AANP. “That happens when states modernize their [scope of practice] regulations. But what this really means for patients, and therefore our profession, because this really isn't about us, is that an extremely diverse set of policymakers, regulators, scholars, provider organizations and the like, all support the notion of NPs simply being able to practice to the fullest extent of their education and national certification.”

Knestrick added that “this acknowledgment from the administration adds an important and influential voice to that growing community of patient-minded professionals looking for ways to curb the primary care shortage and provide patients with the best possible options for accessing the care they need, when and where they need it.”

Currently 22 states, the District of Columbia, and the U.S. territories of Guam and Northern Mariana Islands have enacted full-practice authority for NPs, allowing patients to have direct access to NP care.

“Unfortunately, too many patients continue to face barriers — especially in the Southern and Eastern states,” Knestrick said. “These states not only needlessly lag behind in the full use of NPs, as the recent administration report highlights, but these states are more frequently associated with higher rates of chronic disease like heart disease and diabetes and rank among the lowest for access to primary and preventative care. AANP knows patients deserve and can have better.”

AANP launched a We Choose NPs national campaign earlier this year to raise patients’ awareness about preventive and primary care for good health and limited complications.

“We believe the recommendations related to PAs in this new report are an important step in the right direction,” said Jonathan Sobel, DMSc, MBA, PA-C, DFAAPA, FAPACVS, president and chair of the AAPA Board of Directors, in a statement. “They should surely resonate with stakeholders as we continue to move the profession forward by advocating for PA-practice modernization.”

The HHS report also recommends federal and state governments pay NPs and PAs directly for their services, “where evidence supports that the provider can safely and effectively provide that care.”

RELATED: Recruitment Services for NPs and PAs

Workforce mobility

The HHS report on reforming healthcare also addresses the benefit of healthcare providers working across state lines, including providing care through telehealth. It states, “Markets cannot be as responsive to economic change when workers cannot easily move to meet the demand for their services.”

State-based licensing contributes to the problem, according to the HHS report, which suggests interstate compacts can mitigate the effects of state-based licensing requirements. It encourages states to adopt the compacts or model laws for improving license portability.

“It’s encouraging to see the dialog about ending the patchwork of differences that patients and healthcare providers encounter across the country,” Knestrick said. “As the education, accreditation, certification and practice standards are uniform for NPs, it makes sense that the level of access patients have should be consistent, too. AANP continues to watch the APRN multistate licensure compact very closely.”


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