How Can Nurses Help Improve Access to Primary Care?

The Affordable Care Act (ACA) will bring some 30 million uninsured Americans into a health care system already grappling with an acute need for primary care providers and an aging population with more complex, chronic health problems.

The nation's 3.1 million nurses —who comprise the largest health care profession —play an integral role. Given the demands on the system for primary care and for health care in underserved communities, advanced practical registered nurses (APRNs) are especially critical. APRNs provide high-quality primary care, but a shortage of them, and of the faculty to train them, makes it hard to meet the nation’s growing need for primary care.

They include certified nurse practitioners, certified nurse-midwives and certified clinical nurse specialists, all of whom have post-graduate education and significant clinical training.

State laws and regulatory barriers prevent APRNs from practicing to the full extent of their education and training in many areas, and there are not enough nurse leaders with decision-making authority to overcome those barriers.

Provisions of the ACA aim to increase the nursing workforce, prepare more APRNs and create incentives for more nurses to get advanced degrees and become faculty.

This Health Policy Snapshot, published online in September 2011, examines the obstacles to expanding the APRN workforce.

Read more from RWJF's Health Policy Snapshot series.

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