ACRE Director Discusses Medical Scope of Practice Reform

By Caleb Taylor

What changes can Arkansas legislators make to improve residents’ access to care?

Arkansas’s primary care shortage is a result of its “excessively restrictive” medical scope of practice laws, according to ACRE Director and UCA Associate Professor of Economics Dr. David Mitchell in “Let them practice” published in the Arkansas Democrat-Gazette on March 13th.

Mitchell writes:

One cause of our primary-care shortage is Arkansas’ excessively restrictive medical scope of practice laws. These laws don’t allow qualified, independently practicing nurse practitioners (NPs) to meet Arkansans’ needs in areas where there aren’t enough physicians practicing. That may soon change. House Bill 1254 would allow NPs to be Medicaid primary-care providers, and House Bill 1258 would enable them to attain full practice authority after a three-year transition period. These are great steps toward a healthier Arkansas.”

In the op-ed, Mitchell notes only 5 counties out of 75 in Arkansas are not designated as health professional shortage areas by the U.S. Health Resources and Services Administration.

Mitchell also spoke in favor of House Bill 1254 on March 15th at the Senate Public Health, Welfare and Labor committee. (Mitchell’s testimony begins at 3:06:48 P.M.)

Mitchell said:

The outcomes are what we care about. That’s what’s really important. Arkansas doesn’t have enough providers. We’d like to see more NPs move into these underserved areas. If they can’t see Medicaid patients in underserved areas where most people are on Medicaid, they can’t be financially viable. They can’t open a practice if they won’t be financially viable.”

House Bill 1254 and 1258 both have already passed the House and passed the Senate committee Monday, March 15th. Both will now be considered by the full Senate.

For more on the topic, you can read “A Broad Consensus on Expanding Nurse Practitioners’ Scope of Practice” here.

Check out our one-pager infographic and research distillation.

You can also read another of Mitchell’s recent publications on this issue “Addressing Arkansas’s Health Services Shortages By Empowering Nurse Practitioners” here.

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.