Media Packet NPAM. PO Box 540 Ellicott City, MD 21041

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1 Media Packet What is a Nurse Practitioner NP Facts Who are the Nurse Practitioners in Maryland State of the State Quality of NP Practice NP Cost Effectiveness NPAM PO Box 540 Ellicott City, MD 21041

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4 Who are the Nurse Practitioners in Maryland? There are approximately 3200 nurse practitioners in Maryland Most nurse practitioners in Maryland work in primary care providing health maintenance, care for episodic illnesses and chronic disease management to families, adults and children. Some nurse practitioners work in specialty practices, long term care settings and home care.. Acute care nurse practitioners provide mostly inpatient or emergency care to neonates, children and adults. Psychiatric nurse practitioners work in outpatient and inpatient settings. In Maryland, nurse practitioners (NPs) are legally authorized to independently perform (see COMAR ) 1. Comprehensive physical assessment of patients 2. Establish medical diagnosis for common short term or chronic stable health problems 3. Order, perform and interpret laboratory tests 4. Prescribe drugs 5. Perform therapeutic or corrective measures 6. Refer patients to appropriate licensed physicians or other health care providers 7. Provide emergency care Nurse practitioners in Maryland are required to have a Master s degree and to pass an approved National Board Certification Examination in the area of their specialty. While Maryland NPs are required to have a collaborative agreement with a physician, they may work without a physician on-site in the practice setting. They collaborate with and refer to other members of the health care team. NPs work in every geographic and clinical area of Maryland: employee health centers, universities, student health centers, school health clinics, nursing homes, hospitals, clinics and private offices. NP s are reimbursed as primary care providers under Medicare, Medicaid, CHAMPUS, FEHBP and by many private insurers, including HMO panels. A salary survey in Maryland showed that 42% of nurse practitioner salaries were between $81,000 and $95,000. NPs carry their own malpractice insurance. The National Practitioner Database shows that there is a very low rate of malpractice claims against nurse practitioners. The total number of malpractice claims reported against NPs in Maryland as of 2005 was 7. The 2006 national reported claims against MDs was 1.3 per every 100 MDs per year. Sources: Maryland Board of Nursing, 7/09; Nurse Practitioner Association of Maryland Salary Survey, 2009; Nursing Service Organization: Insurance claims data, 2005

5 800,000 uninsured in Maryland State of the State s Heath in Maryland Serious Primary Care Physician Shortage o 80% Shortage of Primary Care Physicians in Southern Maryland o 68% Shortage of Primary Care Physicians in Western Maryland o 60% Shortage of Primary Care Physicians on Eastern Shore Maryland o There are 16% fewer physicians available for clinical practice in Maryland then the national average The number of internal medicine residents choosing primary care in 2005 was only 20%, (down from 50% since 1997) 65% of nurse practitioners are in primary care. Maryland has Master s prepared, nationally Board certified nurse practitioners, licensed for advanced practice. Nurse Practitioners in Maryland must have a physician agree to a 19+ page collaborative agreement in order to practice that takes 2-4 months for approval. A nurse practitioner who cannot wait 2-4 months for a position must leave the state. Anything added on later must go through the approval process again (even though it is in our Scope of Practice) Maryland requires physicians to sit on the committee at the Board of Nursing to approve collaborative agreements for nurse practitioner practice. No other profession with its own board requires oversight by another professional board. In the United States, 27 out of the 50 states have no collaborative agreement In the Nursing Compact States (states that have a reciprocal agreement to allow Maryland licensed RN s to practice ), 17 out of 23 have no physician involvement in nurse practitioner licensing. Maryland is ranked 42/51 in the American Journal of Nurse Practitioners survey of state practice regulations affecting patient access to NP care, receiving a grade of F If Maryland loses nurse practitioners at the rate that Maryland is losing primary care physicians, then there will be no primary health care available in the rural areas in 5 years. Sources: Task Force on Health care Access and Reimbursement, 2008; US GAO, Feb, 2008; National Resident Match Program, 2005; American Academy of Nurse Practitioners from state nurse practice acts; American Journal of Nurse Practitioners, 4/07

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