title: The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care.
abstract: The provision of health care to low-income Americans remains an ongoing policy challenge. In this paper, I examine how important changes to occupational licensing laws for nurse practitioners and physician assistants have affected cost and intensity of health care for Medicaid patients. The results suggest that allowing physician assistants to prescribe controlled substances is associated with a substantial (more than 11%) reduction in the dollar amount of outpatient claims per Medicaid recipient. I find little evidence that expanded scope of practice has affected proxies for care intensity such as total claims and total care days. Relaxing occupational licensing requirements by broadening the scope of practice for healthcare providers may represent a low-cost alternative to providing quality care to America's poor.
authors.affiliation: Department of Business Administration, Saint Francis University, United States. Electronic address: etimmons@francis.edu.
authors.forename: Edward Joseph
authors.initials: EJ
authors.lastname: Timmons
mesh_terms: D011307:Drug Prescriptions / Q000451:nursing; D006801:Humans; D008484:Medicaid / Q000191:economics*; D009722:Nurse Practitioners / Q000331:legislation & jurisprudence*; D005791:Patient Care / Q000191:economics; D010823:Physician Assistants / Q000331:legislation & jurisprudence*; D011203:Poverty; D024382:Professional Role; D011787:Quality of Health Care; D014481:United States
keywords: Occupational licensing; Occupational regulation