Nurse practitioners’ workforce outcomes under implementation of full practice authority

Background: Full practice authority laws that permit nurse practitioners (NPs) to practice independently and prescribe medications may influence NPs’ workforce outcomes. Purpose: To examine whether implementation of full practice authority laws affect NP self-employment, average earnings, and likelihood of residing in a primary care health professional shortage area (HPSA). Methods: A nationally representative U.S. sample of 9,782 NPs employed in health care during 2010 to 2018 was drawn from the American Community Survey. Difference-in-differences regression was used to estimate covariate-adjusted mean differences in NPs’ workforce outcomes after full practice authority implementation. Findings: Among full-time employed NPs, full practice authority was associated with an increased probability of residing in a HPSA (adjusted odds ratio [aOR]:2.34, 95%CI 1.14, 4.83) and with a higher mean probability of self-employment (aOR:4.97, 95%CI 1.00, 24.86). Discussion: Full practice authority implementation improves access to primary care providers in health professional shortage areas and may increase practice ownership among NPs.