Nurse Practitioners provide equal care for less

Source: New Evidence that Nurse Practitioners Provide Excellent Primary Care Services

The VHA reassigned patients whose primary care physician had left the VHA to either another physician or an NP, independent of the patients’ health, introducing a pseudo‐​random feature to the study. The final sample included 806,434 patients in 530 VHA facilities across the U.S.. After comparing patient conditions pre‐ and post‐​reassignment and between primary care providers, the study found NP‐​assigned patients had similar total costs and clinical outcomes to physician‐​assigned patients and were less likely to require hospitalization.

The pseudo‐​random element of the study addresses the confounding variable of sampling bias. The integrated model of the VHA removed the exogenous variables of patient preference and complexity of health status at the time of reassignment. In addition, the study’s large sample size accomplishes a degree of generalizability that other studies have not. This minimizes the effect of independent variables seen in other studies, enabling researchers to better estimate the association between NP‐​assigned and physician‐​assigned patient outcomes.

Given the spiralling costs of basic general healthcare in the US and the Commonwealth, studies like these continue to show that allowing Nurse Practitioners to have full practice authority would allow a vast increase in carers into the market (lowering costs to consumer) without adversely affecting outcomes (indeed, perhaps even improving some). We call for the Commonwealth to allow full practice authority for NP’s immediately and without delay.


Healthcare in Virginia is beset by a mismatch between high demand and low supply. This is due in part to state regulations that prevent providers from offering more healthcare services and more healthcare facilities. To resolve this crisis of supply and to bring prices down we call for:

* The elimination of Certificate of Need laws at the state and local levels

* Allowing Full Practice Authority for Nurse Practitioners to evaluate patients including examination, diagnosis, ordering and interpretation of diagnostic tests, establishing a treatment plan, and prescribing medication.

* Elimination of restrictions on cash-based / non-insurance based practice, to allow Virginians to procure care without being forced into the insurance bureaucracy.

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