The costs of primary care have been rising and access to it may become limited because of a possible shortage in primary care physicians. Some state governments have addressed this issue by allowing Advanced Practice Registered Nurses (APRNs) to serve the population without the supervision of physicians. About half of the states permit nurse practitioners (NPs) to practice and/or prescribe drugs without physician supervision or collaboration. NPs in primary care charge lower prices than physicians and provide satisfactory quality of care, supported by existent literature. Moreover, increasing the number of NPs could alleviate access problems from a low supply of physicians. NP scope-of-practice (SOP) regulations have been changing in many states. The dissertation focuses on access to health care and addresses three research questions: what is the impact of NP SOP regulations on NP employment, access to primary health care in areas characterized by a relatively low supply of primary care physicians, and how does the Center for Medicaid and Medicare Innovation's Comprehensive Primary Care Initiative affect the use of NPs given state SOP regulations?
