| Description |
This State of the Science review aims to provide a formal understanding of what encompasses a patient-centered medical home (PCMH) and why Nurse Practitioners (NPs) are desirable providers to lead them. In addition, this review examines the barriers and benefits of NP-led PCMHs and how to encourage the continuous growth of the profession while providing low-cost, high-quality patient-centered care. Studies were gathered, assessed, and synthesized to complete this project. A thorough literature review was performed. The research was conducted through scholarly databases using the keywords: patient-centered medical home, APRN, nurse practitioner, NP, benefits, barriers, full practice authority, and scope of practice. Out of 250 studies and articles reviewed, 66 were chosen based on inclusion/exclusion criteria and cited. The inclusion criteria included but were not limited to history of the PCMH, history of NPs, underserved communities, patient satisfaction, research performed within the last five years, studies conducted within the United States. With exclusion criteria of studies older than ten years, physician assistants, studies performed outside the United States, and non-scholarly; databases. Benefits of NP-led PCMHs were found in the following areas: high-quality patient-centered care, increased patient/provider satisfaction, decreased patient out-of-pocket expenses, increased access to primary care, and treatment of underserved communities. Barriers for PCMHs led by NPs included: American Medical Association (AMA) legal pursuits, full practice authority, NP scope of practice limitations, and lack of business/legal education. Despite a plethora of literature supporting the competence and quality related to NP care the AMA continues to facilitate legislative barriers to limit independent practice therefore restricting the ability to lead a PCMH. The literature available provides supporting evidence that NPs are not only capable of providing care, they can provide comparable quality care, increase patient satisfaction, increase access to care, and increase access to underserved communities, which make them perfectly aligned to guide a PCMH independently. |
