Bellot Jennifer, Valdez Brian, Altdoerffer Kristen, Quiaoit Ylenia, Bronzell-Wynder Tanya, Cunningham Patrick
Nurs Econ. 2017 Mar-Apr;35(2):57-63.
Upon implementation of the Affordable Care Act (ACA), many managed care organizations (MCOs) initially increased their nurse practitioner (NP) contracting. This trend has not continued, potentially frustrating ACA efforts to expand primary care provider capacity. In this study, about 25% of the responding MCOs did not contract with NPs as primary care providers. only 62.5% of respondent MCOs offering Medicaid products reported contracting with NPs as primary care providers, suggesting this will place a disproportionate burden on low-income patients seeking to access care. Findings from this study also have important geographic implications, suggesting the decision to contract with NPs is made individually, not necessarily influenced by the numbers of newly insured or available primary care physicians.
《平价医疗法案》（ACA）实施后，许多管理式医疗组织（MCO）最初增加了与执业护士（NP）的签约。但这一趋势并未持续下去，这可能会挫败ACA扩大初级保健提供者能力的努力。在本研究中，约25%的受访MCO没有将NP作为初级保健提供者签约。提供医疗补助产品的受访MCO中，只有62.5%报告将NP作为初级保健提供者签约，这表明这将给寻求医疗服务的低收入患者带来不成比例的负担。本研究的结果也具有重要的地域意义，表明与NP签约的决定是个别做出的，不一定受新参保人数或现有初级保健医生数量的影响。
