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The document contrasts full, reduced, and restricted SOP models, summarizes related prior research gaps, and highlights the Nurse Practitioners Modernization Act adopted in 2015, then outlines a study comparing NP work environments in NY in 2012 versus 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Scope of Practice  \nRegulations in NY State  \nLusine Poghosyan, PhD, MPH, RN, FAAN  \nStone Foundation and Elise D. Fish Professor  \nColumbia University School of Nursing  \nEmail: [lp2475@columbia.edu](lp2475@columbia.edu)  \nAffan Ghaffari, PhD  \nJianfang Liu, PhD  \nHe Jin, M.S.  \nGrant Martsolf, PhD, MPH, RN, FAAN  \nMarch 22, 2021  \nPrimary Care Demand  \n• Demand for primary care services [in the U.S. is](in the U.S. is)   \n• Aging population  \n• Growing chronic disease burden  \n• Insurance expansion  \nAdvanced Practice Nurse Workforce  \n• To meet demand for primary care, increasing the capacity of the healthcare workforce is necessary  \n• One important strategy has been the increasing utilization of the APRN workforce, in particular, nurse practitioners (NPs)  \nNurse Practitioners in the U.S.  \n• Between 2007 and 2019, the NP workforce in the U.S. has more than doubled 1  \n• By 2025, NPs will comprise 27% of all primary care providers in the U.S. 1  \nPolicy and Practice Barriers Faced by NPs  \n•  Scope of practice (SOP) : 27 states require supervisory or collaborative relationships with physicians to provide care  \n•  Organizational barriers: NPs do not have adequate access to organizational resources for optimal practice or face lack of clarity in their role within employment settings  \nState Scope of Practice Categories in the  \nU.S.  \n•  Full: NPs practice independently without involvement of other clinicians2  \n• Reduced: requires NPs to collaborate with a physician  \n• Restricted: requires physician supervision for NP-delivered care  \nNP SOP Map of the U.S.  \nReference: [https://www.aanp.org/advocacy/state/state-practice-environment](https://www.aanp.org/advocacy/state/state-practice-environment)  \nPage 7  \nPrior Research on NP SOP and Gaps  \n•  Full SOP is related to better patient care and outcomes; reduced and restricted SOP limits patients’ access to timely, high-quality care3,4,5  \n• Little is known about the effect of SOP on NP practice and work environment in healthcare organizations  \nNurse Practitioners Modernization Act  \n• Adopted by NY in January 2015  \n• Removed the required written practice agreement between physicians and experienced NPs—with about 2 years of experience  \n• Experienced NPs are able to deliver care to patients without physician involvement6,7  \nPurpose  \n• We examined NP work environment in NY before (2012) and after (2018) the implementation of the new policy.","cbCaikFZ7cIzJe2s","https://ap.wps.com/l/cbCaikFZ7cIzJe2s","pdf",562851,26,"English","# Primary Care Demand\n# Advanced Practice Nurse Workforce\n# Policy and Practice Barriers Faced by NPs\n# State Scope of Practice Categories in the U.S.\n# Nurse Practitioners Modernization Act\n# Purpose and Study Design","[{\"question\":\"What problem does the document address regarding primary care in the U.S. and New York?\",\"answer\":\"It highlights increasing primary care demand driven by population aging, a growing burden of chronic disease, and insurance expansion.\"},{\"question\":\"How does scope of practice (SOP) differ across states according to the document?\",\"answer\":\"States are categorized as Full, Reduced, or Restricted, ranging from independent NP practice to required collaboration or physician supervision.\"},{\"question\":\"What does the Nurse Practitioners Modernization Act change in New York?\",\"answer\":\"It removes the required written practice agreement between physicians and experienced NPs (with about two years of experience), enabling experienced NPs to deliver care without physician involvement.\"}]","State Policy Change and Organizational Response - Expansion of NP Scope of Practice | PDF",1789978946,66]