Nurse practitioners get some autonomy

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Could nurse practitioners get a promotion in the medical field? At least one health insurer is basically treating them like doctors now.

CareFirst BlueCross BlueShield, which serves the Washington, D.C., area, announced this week that nurse practitioners—who are licensed to prescribe medicine—can participate in its networks as primary care providers without supervision by a physician. Before, nurse practitioners could operate independently only in certain medically underserved areas with limited access to primary-care physicians.

The expansion of health insurance coverage under the new federal health law is a big driver of CareFirst’s decision, which won’t go down well with physicians.

"Federal health care reforms will over the next few years result in more residents of our region being covered by health insurance, and that will increase demand for primary-care services," said Bruce Edwards, CareFirst’s senior vice president for networks management. Nurse practiioners also tend to be paid less than physicians, which any health insurer would like.

No similar move has been made by Indianapolis-based WellPoint Inc., which operates Blue Cross and Blue Shield insurance plans in 14 states, including Indiana.

However, some local health care executives already have predicted that so-called physician extenders—which include nurse practiioenrs and physician assistants—soon will become independent, in spite of physician opposition, because there won’t be enough physicians available to provide all the care needed by the aging wave of baby boomers.

The Association of American Medical Colleges predicts a shortage of 124,000 physicians by 2025.

Dan Evans, CEO of the Indianapolis-based hospital system Clarian Health, said in a May speech that physician assistants will get more autonomy, leading them to set up their own offices apart from physicians so they can handle the influx of new patients.

Check out Evans’ comments here.


  • Correct Information
    Please see the recent Institute of Medicine report on the future of nursing, the Patient Protection and Affordable Care Act, The AARP Center to Champion Nursing, The Robert Wood Johnson Foundation, the Macy Report for clear and informed discourse on the role of Nurse Practitioner in primary care. Do a literature reivew of the eivdence of NP outcomes, and lood at the Pearson Report for the national landscape regarding NP practice.
    Factual information is avaiable and is what is needed to manage the health of our citizens. We do not need inflammatory opinion based self-serving turf protecting monologues.
  • Caution
    I would suggest that it would be a good idea to check the current Indiana law regarding potential autonomy for nurse practitioners and physician assistants. Unless changed, it limits their scope of practice to those under physician nsupervision.

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