Nurse practitioners reduce cost, but can they provide high-quality care?

Not all medical problems can or should be treated by a nurse practitioner (NP).  However, may can be.  Increasing access to care through NPs can reduce wait times through expanding access and decrease cost.  The access and cost issues are not in doubt; the question is, can NPs improve or at least maintain patient care?  A recent paper by Traczynskia and Udalova (2018) find that indeed quality of care does improve.

We estimate the causal impact of NP independence on population health care utilization rates and health outcomes, exploiting variation in the timing of state law passage. We find that NP independence increases the frequency of routine checkups, improves care quality, and decreases emergency room use by patients with ambulatory care sensitive conditions. These effects come from decreases in administrative costs for physicians and NPs and patients’ indirect costs of accessing medical care.

• Traczynski, Jeffrey, and Victoria Udalova. “Nurse practitioner independence, health care utilization, and health outcomes.” Journal of Health Economics (2018).