[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-328275-105":59,"doc-detail-328275-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","expanding-nursing-scope-of-practice-to-address-michigans-healthcare-costs-and-physician-shortages","Expanding Nursing Scope of Practice to Address Michigan’s Healthcare Costs and Physician Shortages","","Expanding nursing scope of practice in Michigan is assessed as a policy response to worsening healthcare access pressures driven by physician shortages and rising costs. The brief links constrained patient outcomes and experiences to chronic health needs, Medicaid/insurance expansion, and an aging population, while noting Michigan’s unusually restrictive scope rules for nurse practitioners. Evidence and the FTC position are cited to support independent Advanced Practice Registered Nurse practice with prescriptive authority, while highlighting patient-safety concerns, updates to malpractice liability, and potential payment-policy changes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/expanding-nursing-scope-of-practice-to-address-michigans-healthcare-costs-and-physician-shortages/328275/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/expanding-nursing-scope-of-practice-to-address-michigans-healthcare-costs-and-physician-shortages/328275.png","ImageObject",300,407,{"name":92,"@type":93},"Mason","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why does Michigan need an expanded scope of nursing practice?","Question",{"text":112,"@type":113},"Physician shortages and faster-than-economic growth in healthcare costs threaten patient access, outcomes, and experiences. Expanding scope is presented as a way to increase coverage and reduce cost pressures.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do current state rules affect nurse practitioner prescribing in Michigan?",{"text":117,"@type":113},"The brief states that seven states require written agreements for nurse practitioner prescribing, while many others permit diagnosis and treatment without physician oversight. Michigan is described as having the most restrictive scope of practice regulations in the Great Lakes Region.",{"name":119,"@type":110,"acceptedAnswer":120},"What policy considerations must be addressed when expanding APRN scope?",{"text":121,"@type":113},"Key considerations include potential patient-safety risks from different education and training levels, updating laws for malpractice liability for APRNs working independently, and adjusting third-party payment policies to reimburse APRN services.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},328275,1790332774,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},5909887256941,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","September 2016 | Memorandum 1142  \nExpanding Nursing Scope of Practice to Address Michigan’s Healthcare Costs and Physician Shortages  \nIn Brief  \n• Patient health outcomes, patient experiences, and costs each are threatened by trends in Michigan’s healthcare services. Chronic health concerns coupled with expanded Medicaid and health insurance coverage and an aging population have created a higher demand for physicians, particularly primary care physicians. Healthcare costs are growing faster than the economy as a whole, making quality healthcare less affordable for individuals, businesses, and governments. These and other factors constrict access to healthcare.  \n• Seven states, including Michigan, require a written agreement with a physician for a nurse practitioner to prescribe medication. Eighteen states plus Washington, D.C., permit nurse practitioners to diagnose and treat patients and prescribe medications without physician oversight, while 25 states require oversight of nurse practitioners’ diagnoses, treatment plans, and prescribing of medications. Michigan currently has the most restrictive scope of practice regulations in the Great Lakes Region.  \n• The FTC position and a great deal of independent research supports that Advanced Practice Registered Nurses (APRNs) practicing independently and with prescriptive authority will likely help reduce primary care physician shortages, improve access to healthcare in underserved areas, reduce healthcare costs, and provide care at or above the quality offered by physicians.  \n• The primary considerations for policymakers considering expanding the scope of practice for APRNs include threats to patient safety that might result from care by professionals with less education and training, the need to update laws providing for medical malpractice liability for APRNs working independent of physicians, and voluntary or mandatory changes to third-party payment policies to reimburse APRNs for the services provided.  \n• Michigan’s licensing of advanced practice registered nurses (APRNs), the laws allowing for creation of limited liability companies and allowing for the prescription of medications without written authorization from a physician, and the practices of insurance companies to allow for the direct payment APRNs for their services would need be altered to fully allow advance practice nurses to practice to the full extent of their training and certification.  \n• An ideal healthcare system will create a seamless structure for consumers in which registered nurses, advance practice registered nurses, physician assistants, and physicians create a continuum of care and all health care providers can participate.  \nIntroduction    \nPhysician shortages and rising healthcare costs are just two of the many problems plaguing healthcare today.a Both challenges constrict patient access  \na See Citizens Research Council of Michigan, Where are the Primary Care Physicians? A Look at Michigan’s Primary Care  \nPhysician Shortage, Report 390, June [2015. ](2015.  crcmich.org/)[ crcmich.org/](2015.  crcmich.org/)[ ](2015.  crcmich.org/)[primary_care_physician_shortage-2015/](primary_care_physician_shortage-2015/ and Citizens Research)[ and Citizens Research](primary_care_physician_shortage-2015/ and Citizens Research)[ ](primary_care_physician_shortage-2015/ and Citizens Research)Council of Michigan, Health Care Costs in Michigan: Drivers and Policy Options, Report 383, [May 2013.](May 2013. crcmich.org/health_care_)[ ](May 2013. crcmich.org/health_care_)[crcmich.org/health_care_](May 2013. crcmich.org/health_care_)[cost_drivers_policy_options-2013/](cost_drivers_policy_options-2013/)  \n38777 Six Mile Road, Suite 208 | Livonia, MI 48152 | 734.542.8001  \n115 West Allegan, Suite 480 | Lansing, [MI 48933 | 517.485.9444 | crcmich.org](MI 48933 | 517.485.9444 | crcmich.org)  \nand diminish healthcare quality while requiring individuals, businesses, and governments to spend more money to maintain current ","cbCaiv75GYmyQRxl","https://ap.wps.com/l/cbCaiv75GYmyQRxl","pdf",481189,14,"English","# In Brief\n# Introduction\n# Background","[{\"question\":\"Why does Michigan need an expanded scope of nursing practice?\",\"answer\":\"Physician shortages and faster-than-economic growth in healthcare costs threaten patient access, outcomes, and experiences. Expanding scope is presented as a way to increase coverage and reduce cost pressures.\"},{\"question\":\"How do current state rules affect nurse practitioner prescribing in Michigan?\",\"answer\":\"The brief states that seven states require written agreements for nurse practitioner prescribing, while many others permit diagnosis and treatment without physician oversight. Michigan is described as having the most restrictive scope of practice regulations in the Great Lakes Region.\"},{\"question\":\"What policy considerations must be addressed when expanding APRN scope?\",\"answer\":\"Key considerations include potential patient-safety risks from different education and training levels, updating laws for malpractice liability for APRNs working independently, and adjusting third-party payment policies to reimburse APRN services.\"}]","Expanding Nursing Scope of Practice to Address Michigan’s Healthcare Costs and Physician Shortages | PDF",1789979135,35]