Dr. Richard Lopez, Chief Medical Officer of VNA Care and Senior Vice President of Population Health for Atrius Health, along with Jennifer Derkarzarian, DNP, RN, ANP-BC, Chief Nursing Officer of Atrius Health, recently testified before the Joint Committee on Public Health in support of legislation that would remove existing restrictions on the licenses of nurse practitioners (NPs) in the state. Atrius Health was among several organizations who testified in support of the bill HB2451/S1257 – “An Act to Contain Health Care Costs and Improve Access to Value-Based Nurse Practitioner Care As Recommended by the IOM and FTC.”
During his testimony, Dr. Lopez indicated that as an integrated delivery system, Atrius Health employs well over 300 nurse practitioners at all of its sites and explained that Atrius Health’s nurse practitioners work side by side with physicians as a critical and vital part of our clinical team.
“Increasingly we are utilizing NPs as primary care providers with their own patient panels, which we feel is critical to the patients we care for to improve access to care at a time when there are shortages of primary care providers nationally,” Dr. Lopez noted.
“As a primary care physician myself, I have worked with a nurse practitioner in my practice in Medford since 1982 and can attest to the value our nurse practitioners bring to serve patients in providing quality patient care.” Dr. Lopez added, “As an organization, we believe full practice authority for NPs is vital to improve access, lower costs and reduce unnecessary administrative burdens on physicians.”
House Bill 2451 and Senate Bill 1257 would remove the mandate for physician supervision of NPs for prescriptive practice, eliminating the requirement for practice guidelines with a physician. As currently mandated, review of practice and prescribing guidelines is time-consuming, adding unnecessary waste to the healthcare system. Documentation of a quarterly review of prescriptive practice with a supervising physician is an administrative burden that is time consuming, costly and adds no value to the healthcare system. With respect to Schedule II drugs, requiring physician review every 96 hours is even more onerous and has the potential to impact the ways we are using nurse practitioners across our practices, in skilled nursing facilities, and within the home.
“From a physician perspective, passage of this long-overdue legislation will free me up from unnecessary administrative tasks imposed by current regulations and enable me to spend more time in direct patient care and practicing at the top of my license. In addition, passage of this legislation will provide for needed changes to help organizations such as Atrius Health be better prepared for the many changes underway as we transform the healthcare delivery system in the state,” Dr. Lopez concluded.
During her testimony, Derkazarian pointed out that NPs must adhere to national professional standards and must maintain their own professional malpractice insurance. The literature for over 40 years has substantiated the quality of care provided by these nursing professionals and argued that removing outdated requirements for physician supervision eliminates administrative burdens for the state’s health care delivery system and is philosophically consistent with the landmark passage of Chapter 224 of the Acts of 2012.
“We strongly support this legislation that allows highly skilled NPs to practice to the full extent of their education and training in order to promote the model of patient-centered care that is the hallmark of Atrius Health. Integrated health care systems such as ours should have the ability to determine how best to utilize our NPs to increase access to affordable and quality care. All of our clinicians, including NPs, work with other clinicians and staff across roles and disciplines to provide for population health and chronic disease management, as well as to identify new and better ways to coordinate transitions of care and to provide for better outcomes for our patients,” Derkazarian said.
Atrius Health has been a strong advocate of this legislation that changes state law to permit Atrius Health and other providers to better leverage our workforce, create increased access to care, position the right patient with the right provider in the right care delivery setting, and allow providers to be better prepared for the many changes underway in healthcare today. We strongly encourage the Public Health Committee to act quickly and favorably on this legislation.