Improving Access to Healthcare for Utah Medicaid Clients: The Role of Utah Nurse Practitioners

Utah has been identified as a state with an inadequate supply of primary care providers and, as a result, will be challenged to meet the health care needs of its population. The healthcare demands of the state will continue to increase due to overall population growth as well as a growing population of older adults. Economic security for families and the state is directly impacted by the health status of the citizens and access to primary healthcare has been shown to decrease hospitalizations and lower overall healthcare spending. Utah is also only 1 of 2 states in the United States that reimburses nurse practitioners based on their specialty for services provided to Medicaid clients. Only four advanced practice nurse specialties are currently reimbursed for care provided to Utah Medicaid clients. These include family nurse practitioners, pediatric nurse practitioners, certified nurse midwives and certified nurse anesthetists. Five additional nurse practitioner specialties that are licensed by the state to provide healthcare services to Utah's citizens include adult, geriatric, psychiatric, women's health and acute care nurse practitioners. However, state Medicaid policies currently exclude these practitioners from reimbursement. The expansion of Medicaid eligibility under the Affordable Care Act will place greater demands on the healthcare system statewide. This increased demand coupled with the primary care provider shortage will invariably lead to problems with access to healthcare for many of Utah's citizens. As a result, Medicaid enrollees will continue to be denied access to the timely care from qualified providers. Restructuring reimbursement for services provided to Utah Medicaid clients to include all nurse practitioners licensed to practice in the state of Utah will increase access to healthcare for Utah's Medicaid enrollees. The purpose of this project is to prepare a formal position paper discussing the healthcare provider shortage in Utah, the impact the shortage has on access to healthcare for Utah's citizens and to demonstrate the impact that unencumbered practice and reimbursement for all nurse practitioners may have on both. The intent of this position paper is for it to be used by professional nursing organizations in the state and by other interested stakeholders to promote expansion of Medicaid reimbursement to include all nurse practitioner specialties.