Title: Cost savings of diabetes outcomes: impact of nurse practitioner practice regulatory policy

Authors: Hillary Knepper; Andréa Sonenberg; Helisse Levine

Addresses: Department of Public Administration, Dyson College of Arts & Sciences, Rm. 324, Pace University, 1 Martine Ave, White Plains, New York, NY 10606, USA ' Graduate Department, Lienhard School of Nursing College of Health Professions, Pace University, 861 Bedford Rd, Pleasantville, New York, NY 10570, USA ' School of Business, Public Administration and Information Sciences, Long Island University, Brooklyn, New York, NY 11201, USA

Abstract: The Affordable Care Act (ACA) expanded healthcare coverage to millions of Americans in the context of an existing primary care provider shortage. Nurse practitioners (NP) will play an essential role in expanding access. Maximising their contributions requires fully modernising and standardising NP regulatory policies. Evidence supports associations among NP regulatory policy, access to care, and health outcomes of chronic illnesses. This study examined the relationship between NP regulatory policies in the 50 states and their potential impact on the cost-savings of NP diabetes management. Multiple-block regression identified significant relationships. As the USA continues to implement the ACA, the authors suggest reducing NP scope of practice restrictions will build primary care capacity, increase access and improve health outcomes, and deliver direct and indirect savings for chronic disease management. Modernising nurse practitioner regulatory standards is important to improve cost savings and sustainability for primary care health with particular attention to chronic conditions.

Keywords: Affordable Care Act; Obamacare; primary care capacity; health provider shortage; nurse practitioners; scope of practice; access to care; population health; standards; cost savings; diabetes outcomes; nurses; regulatory policy; healthcare coverage; USA; United States; diabetes management; chronic disease management.

DOI: 10.1504/IJSS.2015.068061

International Journal of Services and Standards, 2015 Vol.10 No.1/2, pp.17 - 31

Received: 05 Jun 2014
Accepted: 23 Oct 2014

Published online: 15 Mar 2015 *

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