Scope of Practice and Opioid Prescribing Behavior of Nurse Practitioners Serving Medicare Beneficiaries

Abstract

Policymakers prioritizing increasing access to health care, while simultaneously keeping costs low and quality high, are considering expanding the scope of practice and prescriptive authority of nurse practitioners. While we know this increases access, some researchers argue that the expansion of job autonomy of nurse practitioners can compromise the quality and safety of rendered medical services. This paper investigates quality and safety outcomes in prescribing behaviors of nurse practitioners who have prescribed opioids for Medicare Part D beneficiaries using a unique source of policy variation, nurse practitioners with the ability to prescribe medication, but move to either states with or without physician supervision. We find that scope of practice expansions do not compromise quality and safety in terms of potential abuse or misuse of prescriptive authority.

Keywords: scope of practice, licensing, nurse practitioners, regulation, Mobility