Does Liberalizing State Nurse Practitioner Scope of Practice Laws Affect the Primary Care Provider Composition and Productivity in Community Health Centers?

The state scope of practice (SOP) laws determine the range of services nurse practitioners (NPs) can provide and the extent to which they can practice independently. This has been a hot topic amid concerns about primary care provider shortages in light of health reform coverage expansion. Many states consider liberalizing NP SOP laws in an effort to expand primary care capacity. As the demand for primary care increases, NPs are expected to have an active role in meeting primary care needs. The purpose of this study was to examine the effects of expanded nurse practitioner (NP) scope of practice (SOP) laws on the composition and productivity of key primary care providers in community health centers (CHCs), including NPs, primary care physicians, and physician assistants (PAs). Key Questions: Does liberalizing state NP SOP laws have an effect on increased hiring of NPs in CHCs? Does liberalizing state NP SOP laws have an effect on NP productivity? Does liberalizing state NP SOP laws have an effect on overall CHC productivity, potentially as a result of changes in roles that may occur across a team