Nurse practitioners

The shortage of primary care physicians in Nebraska’s rural areas has been recently given much-needed attention. Nebraska nurse practitioners share the concerns of our physician colleagues, policymakers and stakeholders that a solution is needed.

Sixty-five of Nebraska’s 93 counties are primary care Health Professional Shortage Areas, and 15 have no primary provider at all. There are disproportionately high and increasing numbers of rural residents over age 65 with chronic disease and disability markers. Mental health workforce data is worse, with 88 HPSAs and 37 counties with no psychiatric provider. The shortage in Nebraska and nationwide will be further compounded with implementation of the Affordable Care Act and the aging of the baby boomer generation.

Nurse practitioners are a solution. The Center for Health Policy at the University of Nebraska’s College of Public Health points out that many rural Nebraska counties already rely on NPs to fill the void. There are 1,080 NPs statewide who may be the only health care provider in some areas. Evidence shows that NP clinical outcomes and patient satisfaction measures meet or exceed physician comparators. In states allowing independent practice for NPs, greater numbers of NPs practice in rural areas. The Rural Health Research Center has encouraged states to consider independent practice for NPs to address rural provider shortages.

Nebraska requires NPs to have an Integrated Practice Agreement with a physician. The IPA can be difficult to obtain and maintain and is a barrier to accessible health care. No evidence supports that requiring an IPA results in higher quality care. Eighteen states, including neighboring Iowa, Colorado and Wyoming, have independent NP practice.
Nebraska Nurse Practitioners is committed to partnering with all of our health care colleagues to find collaborative solutions so that all Nebraskans have access to high quality, affordable health care to maintain the good life.

Cathy Phillips, psychiatric nurse practitioner and Nebraska Nurse Practitioners Legislative Committee chair

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