Tuesday, September 2, 2014
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Nurse-Led Primary Care is the Real Key to Obamacare's Success

There is a lot of confusion and misinformation about how the world of health care is changing around us. Today's concern might be a website that does not work for enrollment, but tomorrow's real issue is the lack of an adequate primary care workforce to meet the needs of the newly insured. Obama's Affordable Care Act takes one major step to address it. The law makes a significant investment in nursing workforce development, specifically in nurse practitioners.

Nurse-Led Primary Care is the Real Key to Obamacare’s Success

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There is a lot of confusion and misinformation about how the world of health care is changing around us.  Today’s concern might be a website that does not work for enrollment, but tomorrow’s real issue is the lack of an adequate primary care workforce to meet the needs of the newly insured.  Obama’s Affordable Care Act takes one major step to address it.  The law makes a significant investment in nursing workforce development, specifically in nurse practitioners.

However, there is more that can be done. Educating and training more nurses is not enough. In order to build primary care capacity, we must invest in models of care that give nurses the opportunity to gain hands on experience delivering community-based care to the underserved.

The Association of American Medical Colleges projects the shortage of primary care physicians will grow to 65,800 by 2025. With over 30 million Americans poised to receive health coverage through the new law, the nation desperately needs to increase the number of primary care providers. To meet this need, the Institute of Medicine’s report on the future of nursing calls upon advanced practice nurses (such as nurse practitioners, nurse midwives, clinical nurse specialists) to fulfill and expand their potential as primary care providers across practice settings.

A large proportion of the newly insured will be in low-income families living in underserved communities. The nation’s 500 nurse-managed health clinics expand primary care access and relieve the burden on the nation’s physicians by utilizing advanced practice nurses and physician assistants to deliver cost effective, high-quality care to the underserved with little or no physician oversight.

In addition to primary care needs, nurse-managed health centers serve as vital “advocates” for millions of Americans as they navigate the Act’s new insurance mandates. When people have a place to go for regular care, such as nurse-managed health clinics, they use it and stay healthy and out of hospitals. We see those with diabetes who are able to control their condition, patients whose lives are saved by a simple medical test, and mothers who no longer have to choose between putting food on the table and getting their children immunized. 

The best way to ensure that advanced practice nurses fulfill their potential as primary care providers and expand access for these patients is to invest in nurse-led care models. This kind of community-based care is already used in nurse–managed and school-based health centers. It can literally save lives.


 

From Obamacare to Medicare to managed care, read more of The Field Clinic here »

Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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