Broadening the scope of nursing practice

To bridge the gap between demand for primary care and available primary care practitioners and establish new approaches to care delivery, health care providers should be able to practice to the fullest extent of their knowledge and competence. This means establishing a broadened scope of practice for nurse practitioners. The Affordable Care Act promises to add 32 million Americans to the rolls of the insured at a time when there is a shortage of primary care providers. There is broad consensus that the next phase of reform must slow the growth of health care costs and improve value through payment reforms, including bundling of payments and payments for episodes of care. Some savings will derive from implementation of innovative models of care, such as accountable care organizations, medical homes, transitional care, and community-based care. We believe that if we are to bridge the gap in primary care and establish . . .