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How Arkansas Can Address Its Shortage of Primary Health Care

By Caleb Taylor

How can Arkansas improve its access to medical care?

Let nurse practitioners practice to the full extent of their education and training, according to ACRE Economic Policy Analyst Dr. Maryam Almasifard in an op-ed “Improve access” published in the Arkansas Democrat-Gazette on March 9. 

Almasifard says:

Residents in rural areas are even more likely to die from preventable causes than those in urban areas, according to the 2019 CDC report “Potentially Excess Deaths from the Five Leading Causes of Death in Metropolitan and Nonmetropolitan Counties–United States, 2010–2017.” Why is this happening? One explanation is that we have a serious shortage of primary-care providers, and primary-care shortages disproportionately affect people in poor and rural areas as well as racial and ethnic minorities. That makes getting access to health services more expensive and difficult than it has to be.”

According to Almasifard, Arkansas faces a growing primary care shortage. 

Almasifard says:

What can we do? Increase access to quality health services, health information, and preventive care. Access to primary care reduces health inequalities and health-care costs by decreasing the need for expensive and unnecessary specialized care. One way to do this is to let Arkansas nurse practitioners (NPs) practice to the full extent of their education and training. The National Academy of Medicine (2010), National Governors Association (2012), and Federal Trade Commission (2014) all support this proposal. All of these organizations have careful studies pointing toward the clear benefits of removing costly restrictions. This is not a radical idea. In 2017, 22 other states and the District of Columbia allowed NPs full practice authority, which includes the ability to legally provide primary-care services. Nurse practitioners are registered nurses with either a master’s or a doctorate in nursing who practice in ambulatory, acute, or long-term care as primary and/or specialty providers. Right now, they are hamstrung by rules requiring them to work under a supervising physician. Our state regulations require NPs to be in a complicated and expensive collaborative agreement with a physician before they can provide services they are educated and trained to provide.”

You can read the entire op-ed here.

Mitchell spoke before both the House and Senate Public Health, Welfare, and Labor committees on February 20 and February 26, 2019 about the need for increased scope of practice for nurse practitioners in Arkansas.

Members of the Senate Public Health, Welfare and Labor committee considered Senate Bill 189 sponsored by Senator Dave Wallace. You can watch the livestream of the committee meeting here. Members of the House Public Health, Welfare and Labor committee considered House Bill 1282 sponsored by Representative Robin Lundstrum. You can watch the livestream of the committee meeting here.

Both bills failed narrowly in committee but increasing awareness about this issue may bring positive changes in the future.  For more of ACRE’s research on nurse practitioners, check out our labor market regulation page.

Mitchell is also the co-author with Jordan Pfaff and Zachary Helms of an ACRE Policy Brief entitled Solving Arkansas’s Primary Care Problems by Empowering Nurse Practitioners.