Nurse Practitioners

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In Idaho, a legislative statue that is currently underway is to reduce the reimbursement parity for Nurse Practitioners (NPs). In Idaho, NPs are paid approximately 85% of what physicians are paid for the same services (Nash, 2018). This is an issue that not only affects Nurse Practitioners in Idaho, but in many other states in the country as well. In Idaho, a state that allows full practice authority, this is a huge disadvantage to NPs wanting to start their own practice as they struggle to maintain a business when they are only reimbursed at 85%. Therefore, they are required to continue to collaborate with MDs (Barnes, et. al., 2017), often billing under the physician NPI number, just to be able to receive full reimbursement for their services. This also leads NPs to be essentially “invisible providers” since they are not using their NPI for their services. In rural areas, where physician shortages occur and the need for primary care providers is greatest, this barrier makes it even harder for NPs to provide those services, jeopardizing access to care. States that have full practice authority and 100% NP Medicaid reimbursement have the highest number of NPs who practice in primary care (Barnes,, 2017).

Both the American Nurses Association (ANA) in Idaho and the Nurse Practitioners of Idaho continually work to have discussions with congressional representatives and stakeholders in healthcare organizations about this issue (Nash, 2018). Nurse Practitioners of Idaho has also been working with the Idaho Department of Health and Welfare to improve reimbursement from Medicaid for Idaho NPs. The Department of Health and Welfare has assured Nurse Practitioners of Idaho their 2021 budget proposal will include pay parity reimbursement with their physician colleagues for primary care codes (Nurse Practitioners of Idaho, 2020). I believe joining and being an active member of state and national professional organizations will help to educate APNs on these legislative issues. They also help identify calls to action, such as writing letters or making calls to legislators, to help push certain initiatives forward. Making our voices heard within the profession, as well as to the patients who rely on our care, regarding these issues that affect our practice is one tactic to help alleviate disparities like this.


Barnes, H., Maier, C. B., Altares Sarik, D., Germack, H. D., Aiken, L. H., & McHugh, M. D. (2017). Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices. Medical care research and review: MCRR, 74(4), 431–451.


Nash, M., DNP, APRN. (2018, February). Exploring reimbursement parity for Idaho’s Nurse Practitioners. RN Idaho, vol. 40(4), pg. 4.


Nurse Practitioners of Idaho. (2020). Recent legislative changes.


original question: Research a health-care initiative or legislative statue that is currently underway in your state or federally. You may want to check with nursing organizations that have legislative departments that can provide their analysis on current health-care issues. You may also conduct online research to identify current issues. Discuss how you can take an active role as a health-care advocate (at the local, state, or federal level as appropriate). Identify one tacitic to advocate for your identified initiative or legislation.

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