reference library

/reference library
reference library2018-06-08T14:23:35-07:00

This website features a collection of links to outside resources, many of which were cited in The Captured Economy, for readers interested in learning more about regressive regulation.

To filter the reference library by topic, please use the links on a topic page or open this page on a full-size screen and use the provided menu.

Who Values Human Capitalists’ Human Capital? Healthcare Spending and Physician Earnings

Joshua D. Gottlieb, Maria Polyakova, Kevin Rinz, Hugh Shiplett, and Victoria Udalova

NBER

July 22, 2020

Is government guiding the invisible hand at the top of the labor market? We study this question among physicians, the most common occupation among the top one percent of income…
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Lack Of Access To Specialists Associated With Mortality And Preventable Hospitalizations Of Rural Medicare Beneficiaries

Kenton J. Johnston, Hefei Wen, and Karen E. Joynt Maddox

Health Affairs

December 2019

People living in rural areas have worse health outcomes than their urban counterparts do. Understanding what factors account for this could inform policy interventions for reducing rural-urban disparities in health….
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Waste in the US Health Care System: Estimated Costs and Potential for Savings

William H. Shrank, Teresa L. Rogstad, and Natasha Parekh

Journal of the American Medical Association

October 7, 2019

The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP). Prior studies estimated that approximately 30% of health…
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Why Are the Prices So Damn High?

Eric Helland and Alexander Tabarrok

Mercatus Center

May 22, 2019

Why are prices in some sectors increasing dramatically even as economy-wide technology and productivity improves? Education and healthcare are notable examples of sectors seemingly stricken by constantly rising prices. Educational…
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Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service

Morris M. Kleiner, Allison Marier, Kyoung Won Park, and Coady Wing

The Journal of Law and Economics

February 2014

Occupational licensing laws have been relaxed in a large number of U.S. states to give nurse practitioners the ability to perform more tasks without the supervision of medical doctors. We…
Read more

PA Scope of Practice Laws

Barton Associates

Barton Associates

All PAs must practice with a collaborating physician; however, state laws dictate the extent of that relationship. This interactive guide provides an overview of PA scope of practice laws by…
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Health spending in OECD countries: obtaining value per dollar.

Gerard F. Anderson and Biance K. Frogner

Health Affairs

2018

In 2005 the United States spent $6,401 per capita on health care-more than double the per capita spending in the median Organization for Economic Cooperation and Development (OECD) country. Between…
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Advanced Practice Registered Nurses

Department of Veteran Affairs

Department of Veteran Affairs

2015

The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting…
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Reforming Health Care Workforce Regulation

Taskforce on Health Care Workforce Regulation

Pew Health Professions Commission

December 1995

” Pew Health Professions Commission endorses the need to reform the regulatory system, the general vision articulated by the Taskforce on the future of the system, and the invitation to…
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Assessing Scope of Practice in Health Care Delivery: Critical Questions in Assuring Public Access and Safety

Federation of State Medical Boards

Federation of State Medical Boards

2005

“The Federation of State Medical Boards (the Federation) is a national non-profit association whose membership includes all medical licensing and disciplinary boards in the United States, and the U.S. territories….
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When Regulations Block Access to Oral Health Care, Children at Risk Suffer

Jane Koppelman

Pew Charitable Trusts

August 20, 2018

This brief describes a range of state-based regulations or policies that either limit or prohibit dental hygienists from sealing children’s teeth at school, or create financial burdens that work against…
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How Medical Licensing Drives Up Health Care Prices

Brink Lindsey and Steven Teles

Pro-Market

November 8, 2017

The role of licensing in driving up healthcare costs has been almost completely ignored. The apparent explanation is that nobody can imagine that there is any alternative. The obvious complexity…
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Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners

Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf

Health Affairs

June 2018

The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence…
Read more

Medicare Graduate Medical Education Funding is Not Addressing the Primary Care Shortage: We Need a Radically Different Approach

Bruce Steinwald, Paul Ginsburg, Caitlin, Brandt, Sobin Lee, and Kavita Patel

Brookings

December 2018

A growing body of evidence shows that areas with robust primary care systems tend to have better outcomes and lower per capita costs than areas that rely more on specialists….
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Nurses as Intermediaries in the Promotion of Community Health: Exploring Their Roles and Challenges

Stuart Butler and Carmen Diaz

Brookings Institution

September 21, 2017

An effective health care system needs to coordinate medical facilities with the behavioral and economic drivers in communities that are most related to good long-term health. Intermediaries can help this…
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Relationship Between State Policy and Anesthesia Provider Supply in Rural Communities

Grant R. Martsolf, Matthew Baird, Catherine C. Cohen, and Nirabh Koirala

Medical Care

May 2019

There is a significant geographic variation in anesthesia provider supply. Lower supply in rural communities raises concerns about access to procedures that require anesthesia in rural areas. State policies related…
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A brief history of pharmacist prescribing in the UK

Wasim Baqir, David Miller, and Graeme Richardson

European Journal of Hospital Pharmacy

September 8, 2012

Pharmacists have been prescribing in the UK since 2003, following the success of nurse prescribing. The review of prescribing, supply and administration of medicines (the second Crown Report) in 1999…
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Improving Efficiency in the Health-Care System: Removing Anticompetitive Barriers for Advanced Practice Registered Nurses and Physician Assistants

E. Kathleen Adams and Sara Markowitz

The Hamilton Project

June 2018

In an era characterized by high levels of U.S. health-care spending and inadequate health outcomes, it is vital for policymakers to explore opportunities for enhancing productivity. Important productivity gains could…
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Impact of Rural and Urban Hospital Closures on Inpatient Mortality

Kritee Gujral and Anirban Basu

NBER

August 2019

This paper examines the impact of California’s hospital closures occurring from 1995-2011 on adjusted inpatient mortality for time-sensitive conditions: sepsis, stroke, asthma/chronic obstructive pulmonary disease (COPD) and acute myocardial infarction…
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Access to Behavioral Health Care in Michigan

Corwin Rhyan, Ani Turner, Emily Ehrlich, and Christine Stanik

Publication name here

Publication date here

This study provides a comprehensive assessment of access to mental health and substance use disorder (SUD) treatment in Michigan. It identifies current challenges and provides a baseline against which progress…
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Review of State Professional and Occupational Licensure Board Requirements and Processes

Commonwealth of Pennsylvania

June 11, 2018

BPOA worked in coordination with Saint Francis University’s Knee Center for the Study of Occupational Regulation (CSOR) to compile data on regional equivalent professional and occupational licensure. The report found…
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How Well Do Doctors Know Their Patients? Evidence from a Mandatory Access Prescription Drug Monitoring Program

Thomas C. Buchmueller, Colleen M. Carey, and Giacomo Meille

NBER

August 2019

Many opioid control policies target the prescribing behavior of health care providers. In this paper, we study the first comprehensive state-level policy requiring providers to access patients’ opioid history before…
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Quality of Primary Care Provided to Medicare Beneficiaries by Nurse Practitioners and Physicians

Peter Buerhaus, Jennfier Perloff, Sean Slarke, Monia O'Reilly-Jacob, Galina Zolotusky, and Catherine DesRoches.

Medical Care

June 2018

Beneficiaries attributed to PCNPs had lower hospital admissions, readmissions, inappropriate emergency department use, and low-value imaging for low back pain. Beneficiaries attributed to PCMDs were more likely than those attributed…
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Change in Site of Children’s Primary Care: A Longitudinal Population-Based Analysis

Richard C. Wasserman, Susan E. Varni, Matthew C. Hollander, and Valerie S. Harder

Analysis of Family Medicine

September 2019

PURPOSE Evidence that fewer children are being seen at family physician (FP) practices has not been confirmed using population-level data. This study examines the proportion of children seen at FP…
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A Snapshot of Occupational Licensing Regulation in the Midwest and Mid-Atlantic States

Kofi Ampaabeng, Conor Norris, and Edward J. Timmons

A Snapshot of Occupational Licensing Regulation in the Midwest and Mid-Atlantic States

August 2020

In this policy brief, we use a novel dataset generated using OL RegData to explore differences in the stringency of occupational licensing for select states in the Midwest and mid-Atlantic…
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An Inclusive Post-COVID Recovery

Michael D. Tanner

Cato Institute

September 15 2020

Whatever one’s opinion of the federal and state government response to the COVID-19 pandemic, the virus and associated “shelter at home” orders clearly had a devastating impact on the U.S….
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Telemedicine & Initiating Buprenorphine Treatment

Bridget C.E. Dooling and Laura E. Stanley

Regulatory Studies Center

23 February 2021

This report concludes that DEA and SAMHSA have the legal authority to extend the flexibilities granted during the COVID-19 public health emergency without additional authorization from Congress. DEA and SAMHSA…
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Burnout and Scope of Practice in New Family Physicians

Amanda K. H. Weidner, Robert L. Phillips, Jr, Bo Fang, and Lars E. Peterson

Annals of Family Medicine

June 2018

Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may…
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Does Occupational Licensing Impact Access to Dental Care?

Brian Isom and Jacob M. Caldwell

Center for Growth and Oppurtunity

August 7, 2019

There is a need in the United States for greater access to dental and oral health services. As of 2018, over five thousand three hundred dental Health Professional Shortage Areas…
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Primary Care Physician Practice Styles and Patient Care: Evidence from Physician Exits in Medicare

Itzik Fadlon and Jessica N. Van Parys

NBER

September 2019

Primary care physicians (PCPs) provide frontline health care to patients in the U.S.; however, it is unclear how their practice styles affect patient care. In this paper, we estimate the…
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Nurse Practitioner Role Grows to More than 270,000

American Association of Nurse Practitioners

American Association of Nurse Practitioners

January 28, 2018

The American Association of Nurse Practitioners® (AANP) released both the new national nurse practitioner (NP) count and findings from its 2018 National Nurse Practitioner Sample Survey. As of January, a…
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Addressing the Nation’s Primary Care Shortage: Advanced Practice Clinicians and Innovative Care Delivery Models

United Health Group

September 2018

Nurse practitioners (NPs), physician assistants (PAs), and certified nurse midwives (CNMs) represent a growing part of the nation’s primary care workforce. These Advanced Practice Clinicians help expand primary care capacity…
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Models of prescribing, scope of practice and medicines prescribed, a survey of nurse practitioners

Jacqueline Fong, Andrew Cashin, and Thomas Buckley

Journal of Advanced Nursing

June 8, 2020

The aim of this study was to explore current Australian Nurse Practitioners (NPs) models of prescribing used and medicines prescribed within their scopes of practice. An online survey of Australian…
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Differences and similarities in scope of practice between registered nurses and nurse specialists in emergency care: an interview study

Erika Boman, Rika Levy-Malmberg, Lisbeth Fagerström

Scandinavian Journal of Caring Sciences

October 2019

 

Wide variation exists between the nursing competence requirements seen in the emergency care context and the subsequent design of nursing education programmes. Clarifying nursing roles and scope of prac- tice…
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A Study of Telecontraception

Tara Jain, Eleanor Schwarz, Ateev Mehrotra

The New England Journal of Medicine

September 2019

Telecontraception is the provision of contraception prescriptions online as an alternative to traditional clinic visits. In this study, standardized patients were asked to represent a range of relative and absolute…
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Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes

Judith Ortiz, Richard Hofler, Angeline Bushy, Yi-ling Lin, Ahmad Khanijahani, and Andrea Bitney

NCBI

June 15, 2018

For decades, U.S. rural areas have experienced shortages of primary care providers. Nurse practitioners (NPs) are helping to reduce that shortage. However, NP scope of practice regulations vary from state-to-state…
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State Medical Boards Awareness Study

The Harris Poll

May 28, 2019

Our aim in conducting the State Medical Boards Awareness Study was to measure national awareness of state medical boards, as well as gain insights on Americans’ experiences with, and responses…
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Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners

Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf

Health Affairs

June 2018

The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence…
Read more

Full Scope-of-Practice Regulation Is Associated With Higher Supply of Nurse Practitioners in Rural and Primary Care Health Professional Shortage Counties

Ying Xue, Viji Kannan, Elizabeth Greener, Joyce A. Smith, Judith Brasch, Brent A. Johnson, and Joanne Spetz

Journal of Nursing Regulation

January 2018

Access to quality primary care is challenging for rural populations and individuals residing in primary care health professional shortage areas (HPSAs). The ability of nurse practitioners (NPs) to provide full…
Read more

The Economic Burden and Practice Restrictions Associated With Collaborative Practice Agreements: A National Survey of Advanced Practice Registered Nurses

Brendan Martin and Maryann Alexander

Journal of Nursing Regulation

January 2019

The U.S. healthcare system is facing workforce shortages in rural and primary care settings. Despite growing demand for providers and comparable quality metrics, advanced practice registered nurses (APRNs) still face…
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Eight Market-Oriented Proposals That Reduce Income Inequality

Dean Baker

American Enterprise Institute

January 24, 2017

Debates over economic policy are often framed as conservatives supporting market-oriented policies, while progressives support government interventions. However, there are many market-oriented policies that can lead to more equality, an…
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Changes in Preparation and Practice Patterns Among New Family Physicians

Amanda K. H. Weidner and Frederick M. Chen

Annals of Family Medicine

November 1, 2018

Family physicians’ scope of practice is declining despite being well prepared to provide a range of clinical services. To evaluate whether this is a new phenomenon, we compared the proportions…
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Reforming America’s Healthcare System Through Choice and Competition

Department of Health and Human Services

December 2018

Reduced competition among clinicians leads to higher prices for health care services, reduces choice, and negatively impacts overall health care quality and the efficient allocation of resources. Government policies have…
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Cross-Sectional Analysis of the 1039 U.S. Physicians Reported to the National Practitioner Data Bank for Sexual Misconduct, 2003–2013

Azza AbuDagga, Sidney M. Wolfe, Michael Carome, and Robert E. Oshel

PLOS One

February 3, 2016

Little information exists on U.S. physicians who have been disciplined with licensure or restriction-of-clinical-privileges actions or have had malpractice payments because of sexual misconduct. Our objectives were to: (1) determine…
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Nurse practitioners: A solution to America’s primary care crisis

Peter Buerhaus

American Enterprise Institute

September 18, 2018

For the past few decades, the United States has not produced enough primary care physicians. Moreover, too few physicians practice in rural and medically underserved areas, and the number of…
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Impact of State Scope of Practice Laws and Other Factors on the Practice and Supply of Primary Care Nurse Practitioners

Westat

Westat

November 16, 2015

“This project explored the effects of nurse practitioner (NP) scope of practice (SOP) legislation on the distribution and practice patterns of NPs as well as their billing practices. The goal…
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Nurse practitioner independence, health care utilization, and health outcomes.

Jeff Tracznski and Victoria M. Udalova

Journal of Health Economics

March 2018

Many states allow nurse practitioners (NPs) to practice and prescribe drugs without physician oversight, increasing the number of autonomous primary care providers. We estimate the causal impact of NP independence…
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How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants.

Kevin M. Stange

Journal of Health Economics

January 2014

Nurse practitioners (NPs) and physician assistants (PAs) now outnumber family practice doctors in the United States and are the principal providers of primary care to many communities. Recent growth of…
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The effects of state-level scope-of-practice regulations on the number and growth of nurse practitioners.

Patricia B. Reagan and Pamela Salsberry

Nursing Outlook

December 2013

It is widely recognized that there is significant state-level variation in scope-of-practice regulations (SSoPRs) for nurse practitioners (NPs). This study was designed to examine whether SSoPRs influence labor markets for…
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State-Granted Practice Authority: Do Nurse Practitioners Vote with their Feet?

John J. Perry

Nursing Research and Practice

November 2012

Nurse practitioners have become an increasingly important part of the US medical workforce as they have gained greater practice authority through state-level regulatory changes. This study investigates one labor market…
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The proportion, conditions, and predictors of emergency department visits that can be potentially managed by pharmacists with expanded scope of practice

Mhd Wasem Alsabbagh and Sherilyn K.D. Houle

Research in Social and Administrative Pharmacy

December 7, 2018

Pharmacists have been shown to be beneficial for inclusion in emergency department (ED) services; however, little has been done to assess these benefits with pharmacists having even wider scopes of…
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The Rise and Impact of Nurse Practitioners and Physician Assistants on their own and Cross-Occupation Incomes

John J. Perry

Contemporary Economic Policy

October 23, 2018

There has been a dramatic increase in the authority granted to nurse practitioners (NP) and physician assistants (PA). This “expanded” authority has changed who can provide health‐care services and has…
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Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients.

GM Oliver, L Pennington, S Revella, M Rantz

Nursing Outlook

December 2014

Strengthening health care overall is essential to the health of our nation and promoting access to health care as well as controlling health care costs in a quality cost-effective manner….
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States With The Least Restrictive Regulations Experienced The Largest Increase In Patients Seen By Nurse Practitioners

Yong-Fang Kuo, Figaro L. Loresto Jr., Linda R. Rounds, and James S. Goodwin

Health Affairs

July 2013

“The use of nurse practitioners (NPs) is one way to address the shortage of physician primary care providers. NP training programs and the number of practicing NPs have increased in…
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Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices.

Leighton Ku, Bianca K. Frogner, Erika Steinmetz, and Patricia Pittman

Health Affairs

January 2015

Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different…
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Relaxing occupational licensing requirements: Analyzing wages and prices for a medical service

Morris M. Kleiner, Allison Marier, Kyoung Won Park, and Coady Wing

Journal of Law and Economics

May 2016

Occupational licensing laws have been relaxed in a large number of US states to give nurse practitioners the ability to perform more tasks without the super-vision of medical doctors. We…
Read more

Diagnostic Imaging Examinations Interpreted by Nurse Practitioners and Physician Assistants: A National and State-Level Medicare Claims Analysis

American Journal of Roentgenology

September 2019

Nonphysician providers (NPPs) increasingly perform imaging-guided procedures, but their roles interpreting imaging have received little attention. We characterize diagnostic imaging services rendered by NPPs (i.e., nurse practitioners and physician assistants)…
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The Effect of State Laws on the Supply of Advanced Practice Nurses

David E. Kalist and Stephen J. Spurr

International Journal of Health Care Finance and Economics

December 2004

This paper considers how the decision to enter advanced practice nursing (e.g., the occupations of nurse practitioner, certified nurse-midwife, nurse anesthetist, and clinical nurse specialist) is affected by State laws…
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Role of Geography and Nurse Practitioner Scope-of-Practice in Efforts to Expand Primary Care System Capacity: Health Reform and the Primary Care Workforce.

JA Graves, P Mishra, RS Dittus, R Parikh, J Perloff, PI

Medical Care

January 2016

“Little is known about the geographic distribution of the overall primary care workforce that includes both physician and nonphysician clinicians–particularly in areas with restrictive nurse practitioner scope-of-practice laws and where…
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The Impact of Establishing a Full Scope of Practice for Nurse Practitioners in Michigan

Grant R. Martsolf and Ryan Kandrack

Rand Corporation

2016

“Policymakers and clinicians are concerned that future growth in demand for health care services will exceed current provider supply. One potential solution to meeting this demand is expanding the number…
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Full Scope-of-Practice Regulation Is Associated With Higher Supply of Nurse Practitioners in Rural and Primary Care Health Professional Shortage Counties

Yue Ying, Viji Kannan, Elizabeth Greener, Joyce Smith, Judith Brasch, Brent Johnson, Joanne Spetz

Journal of Nursing Regulation

January 2018

“Access to quality primary care is challenging for rural populations and individuals residing in primary care health professional shortage areas (HPSAs). The ability of nurse practitioners (NPs) to provide full…
Read more

The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care.

Edward J. Timmons

Journal of Health Economics

2017

The provision of health care to low-income Americans remains an ongoing policy challenge. In this paper, I examine how important changes to occupational licensing laws for nurse practitioners and physician…
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How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants.

Kevin Strange

Journal of Health Economics

2014

Nurse practitioners (NPs) and physician assistants (PAs) now outnumber family practice doctors in the United States and are the principal providers of primary care to many communities. Recent growth of…
Read more

U.S. Health Care from a Global Perspective

David Squires

The Commonwealth Fund

October 8, 2015

This analysis draws upon data from the Organization for Economic Cooperation and Development and other cross-national analyses to compare health care spending, supply, utilization, prices, and health outcomes across 13…
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Use of Midlevel Practitioners to Achieve Labor Cost Savings in the Primary Care Practice of an MCO

Douglas W Roblin, David H Howard, Edmund R Becker, E Kathleen Adams, and Melissa H Roberts

Health Services Research

June 2004

The summary goes here Douglas W Roblin, David H Howard, Edmund R Becker, E Kathleen Adams, and Melissa H Roberts Health Services Research June 2004 External Link

Association of State-Level Restrictions in Nurse Practitioner Scope of Practice With the Quality of Primary Care Provided to Medicare Beneficiaries

Jennifer Perloff, Sean Clarke, Catherine M. DesRoches, Monica O’Reilly-Jacob, and Peter Buerhaus

Medical Care Research and Review

September 2017

State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality…
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The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates

Benjamin J. McMichael, Barbara J. Safriet, and Peter I. Buerhaus

Medical Care Research and Review

January 2017

Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients’ legal burdens in establishing…
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Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

Benjamin J. McMichael

Mercatus Center

July 2017

The increased use of nurse practitioners (NPs) and physician assistants (PAs) represents an important option for increasing access to healthcare. I explore the effect of two types of laws on…
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Competitive Effects of Scope of Practice Restrictions: Public Health or Public Harm?

Sara Markowitz, E. Kathleen Adams, Mary Jane Lewitt, and Anne Dunlop

Journal of Health Economics

October 2016

The demand for health care and healthcare professionals is predicted to grow significantly over the next decade. Securing an adequate health care workforce is of primary importance to ensure the…
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Higher fees paid to US physicians drive higher spending for physician services compared to other countries.

Miriam Laugesen and Sherry Glied

Health Affairs

September 2011

Higher health care prices in the United States are a key reason that the nation’s health spending is so much higher than that of other countries. Our study compared physicians’…
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Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses

Federal Trade Commission

March 2014

This policy paper builds on FTC staff competition advocacy comments that focus on proposed state-level changes to statutes and rules governing the “scope of practice” of Advanced Practice Registered Nurses…
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The Regulation of Occupations

Alex Bryson and Morris M. Kleiner

British Journal Industrial Relations

July 2010

The issue of occupational regulation has been of academic interest from Adam Smith to Milton Friedman (Friedman 1962; Smith 1937). In Western democracies, the number of workers who are required…
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Health Care Spending in the United States Compared With 10 Other High-Income Countries

Howard Bauchner and Phil B. Fontanarosa

Journal of the American Medical Association

2018

In this issue of JAMA, Papanicolas and colleagues compared health care spending in the United States with health care spending in a select group of 10 of the highest-income countries…
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Growth in retail-based clinics after nurse practitioner scope of practice reform.

J. Margo Brooks Carthon, THerese Sammarco, Darcy Pancir, Jesse Chittams, Kelly Wiltse Nicely

Nursing Outlook

March 2017

Retail clinics are largely staffed by nurse practitioners (NPs) and are a popular destination for nonemergent care. We examined if there was a relationship between NP practice regulations and retail…
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Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review.

Ying Xue, Zhiqiu Ye, Carol Brewer, Joanne Spetz

Nursing Outloolkl

February 2016

One proposed strategy to expand primary care capacity is to use nurse practitioners (NPs) more effectively in health care delivery. However, the ability of NPs to provide care to the…
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The Impact of Nurse Practitioner Scope-of-Practice Regulations in Primary Care

Aziza Arifkhanova

Rand Corporation

2018

The costs of primary care have been rising and access to it may become limited because of a possible shortage in primary care physicians. Some state governments have addressed this…
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The Effects of Health Care Industry Changes on Health Care Workers and Quality of Patient Care

Nancy M. Pindus and Ann Greiner

Urban Institute

November 1997

A number of recent studies have called for an overhaul of licensure for health care professionals. Common themes of these studies are increased flexibility in scopes of practice (much of…
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Medical Licensing: An Obstacle to Affordable, Quality Care

Shirley Svorny

Cato Institute

September 17, 2008

In the United States, the authority to regulate medical professionals lies with the states. To practice within a state, clinicians must obtain a license from that state’s government. State statutes…
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The Labor-Market Effects of Occupational Licensing Laws in Nursing

Marc T. Law and Mindy S. Marks

Industrial Relations: A Journal of Economy and Society

September 6, 2017

We study the labor-market impacts of occupational licensing laws on nursing, an economically important occupation. States adopted licensing of registered and practical nurses at different times, which allows us to…
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Changing nature of physician licensure. Implications for medical education in California

C M Dower, C M Gragnola, and L J Finocchio

The Western Journal of Medicine

May 1998

Recent upheavals within health care delivery, technological advances, and changing attitudes among consumers have challenged and changed health professions licensure. At the same time, traditional regulatory frameworks remain in place….
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Medical Licensing: An Obstacle to Affordable, Quality Care

Shirley Svorny

Cato Institute Policy Analysis

September 17, 2008

I argue here that licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible. Institutional oversight…
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Analyzing the Influence of Occupational Licensing Duration and Grandfathering on Labor Market Outcomes

Suyoun Han and Morris M. Kleiner

NBER

December 2017

The length of time from the implementation of an occupational licensing statute (i.e., licensing duration) may matter in influencing labor market outcomes. Adding to or raising the entry barriers are…
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An Examination of the Economic Side Effects of the State Licensing of Pharmacists

Martin SC

University of Tennessee

1982

All of the regressions and test statistics generated to ascertain the effects on pharmacist availability consistently revealed the following: (1) Pharmacist-population ratios, the proxy for pharmacist availability, were found to…
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Physicians Disciplined by a State Medical Board

James Morrison and Peter Wickersham

JAMA

June 17, 1998

State medical boards discipline several thousand physicians each year. Although certain subgroups, such as those disciplined for malpractice, substance use, or sexual abuse, have been studied, little is known about…
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Tapping the Full Potential of Public Members: A Tool Kit for Boards and Community-Based Organizations

NA

Citizen Advocacy Center

July 2009

There are many more examples of ways in which public members can strengthen their boards by raising issues and concerns and introducing agenda items that licensee members are unlikely to…
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A Radical Solution to the Overuse of Occupational Licensing

Tyler Cowen

Bloomberg Opinion

March 5, 2018

Unfortunately, I don’t expect the federal bureaucracy to usher in the reign of Milton Friedman’s Chicago School economics. But the federal regulatory process would likely pay less heed to local…
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Consumers, Complaints, and Professional Discipline: A Look at Medical Licensure Boards

Timothy S. Jost, Linda Mulcahy, Stephen Strasser, and Larry A. Sachs

Health Matrix

1993

State medical licensure boards are widely, if dimly, perceived as the keepers of the gate of the medical profession. When patients or their advocates are aggrieved by physicians, they sometimes…
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Physicians Disciplined for Sex-Related Offenses

Christine E. Dehlendorf and Sidney M. Wolfe

JAMA

June 17, 1998

Disciplined physicians were more likely to practice in psychiatry, child psychiatry, obstetrics and gynecology, and family and general practice than nondisciplined physicians and were older than the national physician population,…
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How Does Government Regulate Occupations in the UK and US? Issues and Policy Implications

Amy Humphris, Morris M. Kleiner, and Maria Koumenta

Oxford University Press

January 2010

We show that in both countries occupational licensing has a large impact on wage determination. The wage premium associated with licensing stands at approximately 18 per cent in the US…
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The Increase in Income Cyclicality of High-Income Households and Its Relation to the Rise in Top Income Shares

Jonathan A. Parker and Annette Vissing-Jorgense

The Brookings Institution

Fall 2010

We document a large increase in the cyclicality of the incomes of high-income households, coinciding with the rise in their share of aggregate income. In the United States, since top…
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Physician Competency: Are We Doing Enough?

Barbara S. Schneidman

The Federation of State Medical Boards

1994

A recent article in the Federation Bulletin by Shirley Svorny, comparing certification with licensure, suggests that medical licensure does not benefit consumers but, instead, serves the interests of physicians by…
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The Case Against Licensing Health Professionals

Stanley J. Gross

Sexual Abuse: A Journal of Research and Treatment

July 1998

Licensing confers a special authority, both literally and figuratively, which increases the likelihood of dependency on licensed personnel. The inequality of information available to the public, compared to the professional,…
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Battles Among Licensed Occupations: Analyzing Government Regulations on Labor Market Outcomes for Dentists and Hygienists

Morris M. Kleiner and Kyoung Won Park

National Bureau of Economic Research Working Paper no. 16560

November 2010

Occupational licensing is among the fastest-growing labor market institutions in the U.S. economy. One of the key features of occupational licensing is that the law determines who gets to do…
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Beyond Medical Licensure

Shirley V. Svorny

Regulation, Spring 2015, pp. 26-29

Spring 2015

Instead of vetting physicians, the licensing apparatus provides an avenue for professional influence that has been used to restrict entry, limit competition, and preclude innovation in the provision of health…
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Continuing Competence in Selected Health Care Professions

Burden S. Lundgren and Clare A. Houseman

Journal of Allied Health

2002

Health services professionals are confronting the challenge of maintaining and improving competence over the course of lengthy careers in diverse practice specialties. This article reviews the efforts of a selection…
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Does Regulation Affect Economic Outcomes?: The Case of Dentistry

Morris M. Kleiner, Robert T. Kudrle

Journal of Law and Economics

October 2000

This study examines the role of variations in occupational licensing policies and practices in improving the outputs of services provided to consumers, and the effect of restrictive regulations on the…
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Performance of State Medical Boards: Implications For Hospitals and Health Systems

Michael Leibert

Hospital Topics

December 2, 2010

The accountabilities and operations of state medical boards can have significant implications for hospitals and health systems in terms of their efforts to ensure quality care and patient safety. This…
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On Professional Power and Conflict of Interest: State Licensing Boards on Trial

Harris S. Cohen

Journal of Health Politics, Policy and Law

Summer 1980

Licensing of the health professions is an issue of public policy which has been under fire for years. Economists argue that licensing stifles competition and increases health care costs. Manpower…
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Job Analysis: A Guide for Credentialing Organizations

Roberta N. Chinn and Norman R. Hertz

Council on Legislature, Enforcement and Regulation

2010

There are also considerations that relate to how the concept of a job analysis will be received by board members and licensees or certificants. First, it is important to determine…
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The Role of Regulation in Quality Improvement

Troyen A. Brennan

The Milbank Quarterly

December 26, 2001

As recently as the late 1960s, most licensure boards were composed of individuals appointed or nominated by medical societies. Only slowly did judicial supervision and legislative control transform licensure boards…
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