The authors describe how advanced practice nurses in Pennsylvania were able to successfully advocate for nursing-related legislative reforms through Governor Edward G. Rendell's signature health care reform plan (the "Prescription for Pennsylvania"). In addition to discussing advocacy efforts related to a series of nursing-related bills considered by the Pennsylvania Assembly in 2007, the article also describes years of hard work and foundational advocacy conducted by a broad coalition of nurses, which paved the way for the Prescription for Pennsylvania's reforms. By examining the successful tactics of Pennsylvania's nurse advocates, the authors conclude that policy makers' current interest in solving the health care crisis presents a tremendous opportunity for nurses to reform legislation. To seize this opportunity, nurses must learn to speak with a unified voice and build strong relationships with a broad range of bipartisan policy makers, funders, civic leaders, business leaders, and legislative advocates.
A national survey showed that most insurance companies refuse to credential nurse practitioners as primary care providers in nurse-managed health centers. These prohibitive policies, along with weak federal and state laws, threaten the long-term sustainability of nurse-managed health centers as safety-net health care providers and limit the ability for nurse practitioners to become an accepted primary health care source in the United States. Interviews with national managed care organizations revealed that these companies' current business practice and policies are unlikely to change without regulatory change at state and/or federal levels.
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