Chair Hilderbrand, Vice Chair Gossage, Ranking Member Pettey, and members of the Senate Committee on Public Health and Welfare, thank you for allowing me to testify on SB 454 and on the subject of regulations governing the licensure of nurse practitioners in Kansas. I am an associate professor of economics and director of the Knee Center for the Study of Occupational Regulation at West Virginia University. I am also a senior affiliated scholar with the Mercatus Center at George Mason University.
On the basis of my own research on the effects of permitting nurse practitioners to practice and use their unique skillsets, I believe that allowing nurse practitioners to practice to the full extent of their specialized training would improve patient access to care without increasing cost or sacrificing quality.
This is an urgent issue because Kansas, like many other states, is facing challenges in providing adequate primary care to patients. National trends suggest that the decline in the population of primary care physicians will continue. Nurse practitioners can potentially help fill this gap. It is important that the law does not block them from practicing to the full extent of their potential.
Nurse practitioners are often restricted by state law when it comes to applying their skills. Removing these barriers would reduce the challenges that vulnerable populations encounter in accessing primary care. Current Kansas law requires nurse practitioners to enter into written protocols with physicians. Kansas would not be going out on a limb by eliminating this requirement. Colorado, Iowa, and 23 other states and jurisdictions already permit nurse practitioners to work without written protocols. Kansas has also temporarily waived this requirement for nurse practitioners in light of the current public health emergency.
Research consistently shows that denying nurse practitioners full practice authority results in longer driving times to receive primary care and reductions in the volume of care provided by nurse practitioners. In addition, researchers consistently find that nurse practitioners are more than capable of providing quality care to patients.
In my own research examining how changes to nurse practitioner practice authority affect Medicaid patients, I find evidence that permitting nurse practitioners to practice autonomously is associated with patients receiving more care without increasing cost. However, my research suggests that the positive effects of granting nurse practitioners autonomy are only fully realized when nurse practitioners are granted full practice authority. These positive effects are quite large—I estimate an 8 percent increase in the amount of care that Medicaid patients receive.
Research continues to demonstrate that nurse practitioners are more than capable of providing high-quality primary care, which is sorely needed. Kansas would not be unique if it were to allow nurse practitioners to work to the full extent of their training without a written protocol with a physician; rather, the state would be keeping policy closer in line with other states and taking steps necessary to ensure that its residents receive the care that they need.