Transforming Health Care Through Evidence and Collaboration
Transforming Health Care Through Evidence and Collaboration
The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to improving the effectiveness, efficiency and quality of America's health care system.
  • Infographics

    Since 2000, the opioid crisis has both grown in magnitude and changed in character. This new series of interactive data visualizations depicts these evolving trends.

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  • Advisory Board

    NIHCM Foundation is pleased to welcome Dr. Scott Gottlieb, Sherry Glied, PhD, and Katherine Baicker, PhD, to its distinguished Advisory Board. Their ideas and insights will advance NIHCM's mission to improve health care for millions of Americans.

    Press Release Advisory Board
  • Awards

    NIHCM Foundation hosted the 25th Annual NIHCM Awards at the Organization of American States in Washington, D.C. to recognize outstanding health care research and journalism.

    Press Release Winners Finalists
  • News

    NIHCM welcomed Secretary Azar to a meeting in March to discuss efforts by the Department of Health and Human Services to transform health care by lowering costs and improving value for patients.

  • Webinars

    As recognition of our country's mental and behavioral health challenges grows, Americans are looking for answers that will increase their happiness and well-being and prevent deaths of despair related to mental health, opioids and suicide. Our four-part webinar series delves into the research and explores innovative strategies and evidence-based solutions to lift our society from crisis.

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  • Grants

    NIHCM Foundation has awarded ten grants for health care journalism including investigative reporting, public engagement campaigns for documentaries and educational opportunities for reporters.

    Press Release All Journalism Grantees Apply for Funding
  • Grants

    NIHCM has awarded over $400,000 in grants to support seven investigator-initiated research studies on topics including value-based drug pricing and Medicaid expansion.

    Press Release All Research Grantees Apply for Funding
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Events

August 29, 2019
Early-Childhood-Webinar-Graphic

This webinar explored how high-quality early childhood education (ECE) has an enormous positive impact on lifelong health, serving as a protective factor against adult disease and disability.

August 28, 2019
Allliance-Webinar-Aug2019

During this webinar, experts shared their thoughts on what health care policy activity might be expected before the end of 2019.

In the News

September 2019
Population Health Spotlight
in-the-news 2

Meeting the Demand for Primary Care: Nurse Practitioners Answer the Call

John Iglehart, Founding Editor, Health Affairs

Rapidly expanding insurance coverage and a growing and aging population are increasing the demand for health care services and the personnel who provide them. Despite a robust increase in the supply of physicians following unprecedented increases in medical school capacity in recent years, the Association of American Medical Colleges (AAMC) still projects a shortage of 130,000 physicians by 2025, split almost equally between primary and specialty care.1 At the same time, delivery and payment system reforms may already be changing the mix of personnel needed to respond to the rising demand for health care services. In this essay I consider the potential role that nurse practitioners (NPs) can play in supplementing physician supply, describing trends in the profession and developments related to state laws regulating their scopes of practice (SOP).

Nurse Practitioners "On the March"

Nurse practitioners are one of several types of personnel considered to be advanced practice registered nurses (APRNs); nurse anesthetists, nurse midwives, and clinical nurse specialists are also APRNs. The vast majority of current NPs hold a master’s degree (86 percent) or a doctorate (5 percent) in nursing. As of 2012, there were an estimated 154,000 licensed NPs in the U.S., 127,000 of whom were providing patient care. Slightly under half of those worked in primary care.2 Over the past decade, the annual number of NP graduates more than doubled to reach 14,400 graduates in 2012, and continued growth is expected. One study projects a near doubling of the total NP workforce by 20253 while another predicts the number of NPs providing primary care will increase by 30 percent by 2020.4

The shorter and less costly training pipeline for NPs relative to physicians, combined with evidence that NPs provide high quality care and achieve high patient satisfaction,5,6,7 argue in favor of the profession’s ability to quickly and effectively meet growing demand for health care services. Numerous provisions of the Affordable Care Act – including grants for nurse-managed clinics, significant financial support for NP training, and emphasis on team-based models of care – clearly envision NPs as an integral part of the future health care workforce. Recent evidence points to consumer acceptance of NPs,8 and the profession has strong backing from influential consumer advocates, including the AARP and the Robert Wood Johnson Foundation. Major corporations are also relying on NPs to staff their expanding networks of retail health clinics.

Despite this momentum, however, the efforts of NPs have been stymied in some states by laws preventing them from providing all services they are trained to provide and by requirements for physician oversight. Reflecting long-simmering disputes over “turf” and citing concerns about patient safety and quality of care due to the shorter training period, the American Medical Association (AMA), the American Academy of Family Physicians and their allies oppose SOP expansions and advocate that NPs should provide primary care within the construct of a patient-centered, physician-led team.

The Move to Expand Scopes of Practice

SOP battles are playing out across the country. The National Conference of State Legislatures reports that 100 bills related to NP scope of practice were introduced in 22 states between 2011 and mid-2013, with about one-quarter enacted. The combatants spend enormous sums of energy, money and time arguing their cases before state legislatures at a time when, ironically, collaborative care is seen as the goal at the practice level.

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Events

August 29, 2019
Early-Childhood-Webinar-Graphic

This webinar explored how high-quality early childhood education (ECE) has an enormous positive impact on lifelong health, serving as a protective factor against adult disease and disability.

August 28, 2019
Allliance-Webinar-Aug2019

During this webinar, experts shared their thoughts on what health care policy activity might be expected before the end of 2019.

In the News

September 2019
Population Health Spotlight
in-the-news 2

Grants

Journalism GrantsJournalism Grant Program

We are no longer accepting letters of inquiry for the 2019-2020 round of grantmaking. NIHCM will notify grant winners in November 2019.

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NYTUpshotLogo

Investigator-Initiated Research Grant Program

We are no longer accepting letters of inquiry for the 2019-2020 round of grantmaking. A small number of applicants will be invited to submit a full proposal in September.

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Awards

Winners Named in the 25th Annual Research and Journalism Awards

Winners Announcment 2018 1

Congratulations to all of the winners of the 25th Annual NIHCM Foundation Research and Journalism Awards! The winners and finalists were honored at a banquet in Washington, DC, in May.

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