Why the AANP and its new president Stephen Ferrara are advocating for nurse practitioners to have authorization to provide more services.
The American Association of Nurse Practitioners (AANP) recently appointed Stephen A. Ferrara, DNP, as the association’s new president. Ferrara is an actively practicing nurse practitioner with years of experience in a clinical setting and in health policy development. He is currently a member of the senior leadership team at Columbia University’s School of Nursing, serving as the associate dean of clinical affairs and assistant professor. According to a press release announcing his new role, Ferrara will work to lead the organization in advancing the role of the nurse practitioner through healthcare policy, research and innovation, and promoting high-quality patient care. Repertoire Magazine recently spoke to Ferrara about his new term as president of the AANP and how he plans to lead the association.
What do you anticipate will be some of the areas of focus for AANP during your tenure as president?
Stephen Ferrara: As AANP President, I am proud to carry out the mission of our organization, which is to empower all nurse practitioners (NPs) to advance accessible, person-centered, equitable, high-quality health care for diverse communities through practice, education, advocacy, research and leadership. AANP continues to be focused on solutions that move the health care system forward. There are 355,000 NPs caring for patients in nearly every health care setting across our county. Every day NPs deliver high-quality care to their patients, improving the access, delivery, outcomes and efficiency of our nation’s health care system. Therefore, some of my focus areas will include partnering with stakeholders to diversify the NP workforce and modernize policies that interfere with care.
The AANP advocates for Full Practice Authority. Can you explain to our readers what that is and the importance of it to the delivery of healthcare in the U.S.?
Ferrara: NPs assess patients; order, perform, supervise and interpret diagnostic and laboratory tests; make diagnoses; initiate and manage treatment, including prescribing medication and non-pharmacologic treatments; coordinate care; counsel; and educate patients and their families and communities. NPs hold prescriptive authority in all 50 states and the District of Columbia (D.C.) and perform more than 1 billion patient visits annually. Currently, 27 states, the D.C. and two U.S. territories have adopted Full Practice Authority (FPA), granting patients full and direct access to NPs and the high-quality health care we provide.
It is important to note that FPA is the term used to refer to the licensure laws that authorize NPs to provide these vital services under the exclusive regulation of the state board of nursing. FPA creates greater access to care and more choice for patients and health care systems. FPA also avoids the duplication of services and unnecessary costs.
What do you anticipate legislatively on the federal level to have an impact in the coming years?
Ferrara: NPs are the fastest growing health care provider type in the U.S., and millions of Americans
are choosing NPs for their primary care. Notwithstanding the fact that NPs provide a significant amount of health care to patients across the country, federal barriers still remain that impede timely access to care. We have seen barriers be retired, resulting in better access to home health care and to medication-assisted treatments for substance use disorders. During the COVID-19 public health emergency, multiple outdated barriers were suspended, which allowed for better access and more efficiency. As the nation recovers from the pandemic and looks to build a stronger, more effective health care system, we believe the lessons learned over this time will provide a clear road map to modernizing the outdated policies that currently impede patient care.
For example, the Improving Care and Access to Nurses (ICAN) Act has been introduced in the current session of Congress. This critical legislation would improve health care access for Medicare and Medicaid beneficiaries by removing barriers to practice for nurse practitioners and other advanced practice registered nurses. It is important that Medicare and Medicaid beneficiaries have timely access to high-quality care.
What are some of the most pressing challenges nurse practitioners face today?
Ferrara: NPs serve at the intersection of patient care and institutional and health care policies. Every day we see firsthand how inefficiencies negatively impact our patient’s health, and we are committed to being a solution. Policies that limit NPs from delivering the level of care that they are educated and clinically trained to provide create system challenges, like delays in care, increased administrative burdens, unnecessarily duplicated efforts and increased costs. These challenges lead to clinician burnout and broad health care system inequity and inefficiency. As health care continues to evolve, it is incumbent upon all of us to enact policies that acknowledge and reflect who is providing care to patients. NPs are a critical solution to health care access and increased efficiency, and we look forward to working with policymakers and health system leadership to ensure patients have access to their chosen health care providers.
Sidebar: 1
Nurse Practitioners By the Numbers
The following facts and figures are provided by the AANP on its website.
- There are more than 355,000 nurse practitioners (NPs) licensed in the U.S.1
- More than 36,000 new NPs completed their academic programs in 2020-2021.2
- 88.0% of NPs are certified in an area of primary care, and 70.3% of all NPs deliver primary care.3
- 83.2% of full-time NPs are seeing Medicare patients and 81.9% are seeing Medicaid patients.3
- 45.6% of full-time NPs hold hospital privileges; 10.9% have long-term care privileges.3
- 96.2% of NPs prescribe medications, and those in full-time practice write an average of 21 prescriptions per day.3
- NPs hold prescriptive privileges, including controlled substances, in all 50 states and D.C.
- In 2021, the median base salary for full-time NPs was $113,000.3
- The majority of full-time NPs (56.9%) see three or more patients per hour.3
- NPs have been in practice an average of 9 years.3
- The average age of NPs is 46 years.3
Sources:
1 AANP National Nurse Practitioner Database, 2022.
2 American Association of Colleges of Nursing (AACN). (2022). 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. Washington, DC: AACN.
3 2022 AANP National Nurse Practitioner Workforce Survey — Preliminary Analysis.
Sidebar 2:
Survey: 26% of Patients Wait Two or More Months for Care
The American Association of Nurse Practitioners® (AANP), the nation’s largest professional membership organization for nurse practitioner (NPs), released the results of a new national survey of U.S. adults conducted in April 2023 that found more than 40% of respondents have experienced a “longer than reasonable” wait for health care. According to the survey, nearly half of those who experienced unreasonable wait times gave up seeking an appointment and did not receive care. This includes patients seeking critical mental health services.
“These results are an eye-opening look at the state of access to care in our health care system,” said AANP President Stephen Ferrara, DNP. “A lack of timely access to care, particularly primary and preventive care, can lead to chronic conditions that put patients’ lives in danger and increase costs. Delayed or deferred care can put an individual’s health at greater risk for complications, which may also lead to a negative impact on mental health and lost wages for those patients. A decline in productivity for employers may also occur.”
Among those surveyed, 26% reported waiting more than two months to gain access to a health care provider. This situation extends across all major demographics, including age, gender and education, and it impacts access to care in all geographic areas, including rural, suburban and urban settings. Those most likely to give up on seeing a provider after a lengthy wait include younger adults, people living in urban areas and respondents who reported their ethnicity as Hispanic.
“As a nation, we can solve the growing crisis in access to care by modernizing the outdated policies that sideline NPs from delivering care they are educated and clinically prepared to provide,” said AANP Chief Executive Officer Jon Fanning MS, CAE, CNED. “We can help shorten wait times and give patients timely access to the care they need by removing barriers to America’s 355,000 NPs.”