Nebraska is a largely rural state with many communities defined as medically underserved by primary care providers. In 2014, the state legislature voted to eliminate the requirement for an integrated practice agreement (IPA) between nurse practitioners (NPs) and physicians. This report describes changes in access to primary health care in rural and underserved areas of Nebraska after removal of the IPA barrier to practice. The report compares the number of primary care NPs working in medically underserved areas before and after the legislation that ended the required IPA. In addition, anecdotes will be provided of NP and patient experiences in rural, NP-owned practices in Nebraska after IPA requirements were eliminated.
College of Nursing, University of Nebraska Medical Center, Lincoln, Nebraska
Correspondence: LeAnn A. Holmes, DNP, APRN, FAANP, UNMC College of Nursing, Lincoln Division, 550 N 19th St, HCCN 310L, Lincoln, NE 68558; E-mail: firstname.lastname@example.org
Competing interests: The authors report no conflicts of interest.
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Authors' contributions: The analysis of data was performed by Holmes with significant editorial input by Waltman.
Received August 08, 2018
Accepted September 26, 2018