ANA Responds to the Administrations Report on Reforming America's Healthcare System 

December 4, 2018 

The Department of Health and Human Services (HHS), in collaboration with the Departments of the Treasury and Labor, the Federal Trade Commission, and several offices within the White House, has released a report titled Reforming America’s Healthcare System Through Choice and Competition. The report is recommendations to improve the health care workforce and labor markets, health care provider markets, health care insurance markets and consumer-driven health care.

The American Nurses Association (ANA) is pleased that the report recommends broader scope-of-practice (SOP) statutes for all health care providers, including advanced practice registered nurses (APRNs), that allow them to practice to the top of their license and full skill set. ANA is gratified that the report advises eliminating rigid “collaborative practice” and supervision requirements which can impede consumer’s access to care and limit the ability of providers to diagnose and treat a myriad of health care conditions. Removing these barriers to optimal practice is essential for underserved populations and in rural areas where patients rely on APRNs for timely care and lifesaving treatment.

The research is vast and the evidence is clear – nurses consistently deliver high quality care with positive patient outcomes. The Institute of Medicine (now the National Academies of Sciences, Engineering, and Medicine) in its 2010 report, “The Future of Nursing: Leading Change, Advancing Health,” clearly stated that APRNs “should be allowed to practice to the full extent of their education and training.” APRNs practice advanced nursing, not medicine, in which they regularly consult, collaborate and refer as necessary to ensure that the patient receives appropriate diagnosis and treatment.

While some states have granted full practice authority to APRNs, there is still significant room for improvement. ANA will continue to advocate strategies, legislation and regulations, such as the 2016 Department of Veterans Affairs Advanced Practice Registered Nurses Rule, that support APRNs and their proven ability to care for patients. ANA supports the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education that was agreed to in 2008.  The four roles included within the APRN Consensus Model are Nurse Practitioner (NP), Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNAs), and Clinical Nurse Specialist (CNS).