Informing Health Policy Decision Makers: A Nebraska Scope of Practice Case Study

Abstract

Medicare patients seeking care from nurse practitioners (NPs) increased 15-fold from 1998 to 2010, and a 2.5-fold patient increase was recorded in states that have eased the regulatory environment for NPs. It is increasingly important that state regulatory and licensing boards—charged with protecting the public through the assurance of a qualified health-care workforce—examine whether their state regulatory environment restricts or promotes public access to quality health care. This article presents a case study of a statutory scope of practice credentialing review process for NPs in Nebraska. It examines in depth what individuals involved in policy change processes found most useful for informed decision making. The methodology included observation of the process, review of submitted documents, and a survey to individuals involved in the decision-making process (n = 22/48). The study findings have application for those seeking scope of practice policy changes, with specific suggestions for how to better prepare themselves and present information in formats that are helpful to decision makers. Our results also shed new light on what specific evidence submitted during a scope of practice review process is most valued for promoting the understanding of decision makers to effect change.