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The Shift in Nursing: Policy Changes Every Advanced Practice Nurse Must Prepare For

Emerging Advanced Practice Nursing Policy Issues

Advanced Practice Registered Nurses (APRNs) face evolving challenges in today’s healthcare landscape. With the rise of emerging policies, it’s essential to explore how these policies affect the practice of APRNs and the future of healthcare delivery. Critical policy issues include workforce development, data inadequacies, billing processes, and the political landscape shaping the future of nursing. Understanding these issues is crucial to advancing the nursing profession.

Workforce data plays a pivotal role in influencing policy related to APRNs. However, there’s a notable gap in data adequacy and census, which makes it challenging to define the true impact of APRNs in healthcare. Data from the U.S. Department of Health and Human Services, National Sample Survey of Nurse Practitioners (HRSA, 2014), and other sources such as the American Association of Nurse Practitioners (AANP, 2019), are critical in analyzing workforce trends but require improvement. Reliable data collection is necessary to answer key policy questions quickly and effectively.


Table: APRN Workforce Data Sources

Data SourceTypeMost Recent YearFocus
U.S. Dept. of Health and Human Services (HRSA)National Sample Survey of Nurse Practitioners2014Workforce trends for Nurse Practitioners
American Association of Nurse Practitioners (AANP)National Nurse Practitioner Sample Survey2019NP practice environment and trends
National Association of Clinical Nurse SpecialistsCNS Census Survey2018Workforce data for Clinical Nurse Specialists
Bureau of Labor StatisticsOccupational Employment Statistics2020Employment data for NPs, CRNAs, CNMs

For more details, visit HRSA.gov.


The Impact of Policy on APRN Billing and Recognition

A significant policy issue affecting APRNs is how services are billed. When APRN services are billed under “incident-to” physician services, the true value of APRN contributions becomes invisible in healthcare metrics. This invisibility can diminish their role in policy discussions, leading to underrepresentation in decision-making processes. Ensuring APRNs are recognized for their independent contributions is vital for evaluating their work quality and outcomes.

A model for effective data collection lies in nurse-managed clinics, where APRNs play a direct role in patient care. These clinics, recognized by the National Committee for Quality Assurance as patient-centered medical homes, have robust systems in place to collect and report data, enabling APRNs to demonstrate their value more effectively.

Political Engagement and Advocacy

In the current political climate, it is increasingly important for APRNs to engage with the political process. Given the inherently political nature of healthcare in the U.S., APRNs must advocate for policies that support their role in improving patient outcomes and access to care. This engagement includes participating in policy discussions, influencing healthcare reform, and ensuring APRN data is used to drive decision-making.


Key Policy Issues Facing APRNs

  • Data Inadequacies: The lack of updated and reliable workforce data remains a major hurdle in APRN policy development. Addressing these gaps is essential for understanding the full impact of APRNs on healthcare outcomes.

  • Billing and Reimbursement: The “incident-to” billing issue continues to obscure the value of APRN services, making it difficult to demonstrate their independent contributions.

  • Workforce Development: Ensuring a steady pipeline of well-trained APRNs is critical for meeting healthcare demands, but workforce data collection efforts must be improved to support this.

  • Political Involvement: APRNs must continue to engage in political advocacy to ensure that their voices are heard in healthcare reform discussions.


FAQ on Emerging Advanced Practice Nursing Policy Issues

Q: Why is reliable workforce data so important for APRN policy? A: Accurate and up-to-date workforce data helps policymakers understand the contributions of APRNs, identify workforce gaps, and ensure policies support the growth and recognition of APRNs.

Q: How does the “incident-to” billing process affect APRNs? A: When APRN services are billed under a physician’s services, the value of their independent work is often attributed to the physician, leading to underrepresentation in workforce data and policymaking.

Q: What role do nurse-managed clinics play in policy development? A: Nurse-managed clinics serve as models for effective data collection and reporting. They demonstrate how APRNs can independently manage patient care and outcomes, providing valuable insights for policymakers.

Q: How can APRNs get involved in shaping policy? A: APRNs can join professional organizations, participate in advocacy groups, and engage with political leaders to influence healthcare reform and policy development.

Q: What are the key emerging policy issues APRNs should be aware of? A: APRNs should focus on workforce development, billing and reimbursement practices, data collection inadequacies, and political advocacy to address the most pressing policy issues in their field.


By addressing these emerging policy issues, APRNs can enhance their role in shaping the future of healthcare. Ensuring reliable data collection, advocating for better billing recognition, and engaging in political advocacy are critical steps in advancing the profession and improving patient care outcomes.

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