Nashville — The role of nurse practitioners in educating patients about healthcare reform, the availability of national programs to aid expansion of the profession and state legislation granting full practice authority to NPs were highlighted during the opening session of the American Association of Nurse Practitioners 2014 meeting.

As more Americans gain health insurance, NPs will play a vital role in expanding access to care in light of the ongoing primary care physician shortage, Mary K. Wakefield, PhD, RN, administrator for the Health Resources and Services Administration (HRSA) division of the U.S. Department of Health and Human Services, told an audience here.

“There’s still a lot of work to do to continue to educate the uninsured about new options available under the Affordable Care Act,” she said. “Too often even people who have health insurance coverage may not be aware of new benefits, may think incorrectly that preventive services like mammograms are not covered, or may not understand why screening matters. These people need help from you to understand the range of benefits health insurance provides.”

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Wakefield outlined several federally funded programs aimed at boosting the primary care infrastructure that aid NP progress.

An $11 billion HRSA investment has funded 9,500 new community health centers under the ACA.  These new sites currently employ 4,700 NPs and more than 500 certified nurse midwives and have expanded access to care from 17 million to 21 million people.

President Obama’s fiscal year 2015 budget aims to continue this commitment to community health by allocating funds necessary to open an additional 150 centers in efforts to expand access to more than 31 million Americans, Wakefield said.

Additionally, the National Health Service Corps (NHSC) offers loan repayment and scholarship programs for primary care health providers serving at NHSC sites in underserved communities, with reimbursement packages ranging from $40,000 to $60,000 in exchange for services.

“This program is critical to getting primary care providers to places where our country needs them the most and to address the educational debt that many clinicians are graduating with,” Wakefield said.

During the past five years, the NHSC ranks have grown from 3,600 clinicians to nearly 8,900 primary care providers, including 1,600 advance practice nurses. “That number represents more than three times as many NPs, CNMs and psychiatric nurses as there were at the beginning of President Obama’s first term,” she added.

Another national initiative Nurse Corps, a home visiting program, currently supports 2,500 nurses and 480 nurse practitioners who practice in partnership with social workers counseling parents and children in underserved communities using evidence-based strategies to improve health outcomes.

“We’re working very hard to strengthen the competencies NPs will need to practice in redesigned healthcare systems. HRSA supports initiatives to help transform the present siloed healthcare system into an integrated system that reflects care coordination and team-based practices,” Wakefield said.

At the state level, NPs currently hold full practice authority in 19 states, enabling them to run practices autonomously without physician oversight. The most recent states to pass NP-friendly legislation were Connecticut and Minnesota this past May.


  1. Wakefield MK. #14.2.012. Presented at: AANP 2014. June 17-22, 2014; Nashville, Tenn.