Impact Of The New Jersey COVID-19 Temporary Emergency Reciprocity Licensure Program On Health Care Workforce Supply

Nguyen, Ann M.; Schaler-Haynes, Magda; Chou, Jonathan; Wetzel, Matthew; Koller, Margaret; Yedidia, Michael J.; Cantor, Joel C.

doi:10.1377/hlthaff.2022.00249

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Similarly, it may still be too early to fully assess the effects of these temporary policies on workforce and patient outcomes. One early study found that out-of-state licensing flexibilities in response to COVID-19 expanded the respiratory therapist and nurse workforce in New Jersey, 84 while another study suggests that emergency SOP expansions did not always result in practice changes for nurse practitioners. 85 Underlying this study is the idea that explicit directives issued by the governor are important.…”

Section: Discussionmentioning

confidence: 99%

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic

et al. 2023

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Objectives: In times of heightened population health needs, the health workforce must respond quickly and efficiently, especially at the state level. We examined state governors’ executive orders related to 2 key health workforce flexibility issues, scope of practice (SOP) and licensing, in response to the COVID-19 pandemic. Methods: We conducted an in-depth document review of state governors’ executive orders introduced in 2020 in all 50 states and the District of Columbia. We conducted a thematic content analysis of the executive order language using an inductive process and then categorized executive orders by profession (advanced practice registered nurses, physician assistants, and pharmacists) and degree of flexibility granted; for licensing, we indicated yes or no for easing or waiving cross-state regulatory barriers. Results: We identified executive orders in 36 states containing explicit directives addressing SOP or out-of-state licensing, with those in 20 states easing regulatory barriers pertaining to both workforce issues. Seventeen states issued executive orders expanding SOP for advanced practice nurses and physician assistants, most commonly by completely waiving physician practice agreements, while those in 9 states expanded pharmacist SOP. Executive orders in 31 states and the District of Columbia eased or waived out-of-state licensing regulatory barriers, usually for all health care professionals. Conclusion: Governor directives issued through executive orders played an important role in expanding health workforce flexibility in the first year of the pandemic, especially in states with restrictive practice regulations prior to COVID-19. Future research should examine what effects these temporary flexibilities may have had on patient and practice outcomes or on permanent efforts to relax practice restrictions for health care professionals.

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Section: Discussionmentioning

confidence: 99%

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic

et al. 2023

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“…Early in the pandemic, most states relaxed or eliminated interstate licensure requirements, allowing providers to seamlessly provide COVID-19 countermeasures across state lines. 69 , 70 , 71 The pandemic demonstrated that temporary interstate licenses were able to alleviate areas with surging provider demand and address healthcare workforce shortages, 72 notably enabling hyperspecialized care to move to areas of need. 73 Extending to dermatology, cross-state licensing would also permit patients to access out-of-state dermatologists, increasing patients’ total number of available providers and potentially mitigating state-based disparities in number of dermatologic providers.…”

Section: Interstate Licensurementioning

confidence: 99%

Evolving teledermatology policy and reimbursement landscape in the United States

Lin¹,

Deitermann²,

Miller³

et al. 2023

JAAD International

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“…Out-of-state health care is of paramount importance for patients residing in health professional shortage areas to access specialty services, including mental health care, and mitigate shortages in PHE hotspots. 9 , 10 In-state licensure requirement waivers (licensure waivers) represent state-issued policy changes during the PHE that allow providers to deliver tele-mental health care beyond their licensed states. In the presence of large unmet needs, this mechanism of licensure portability may alleviate health care shortages by providing access to out-of-state health care for patients near state borders.…”

Section: Introductionmentioning

confidence: 99%

Association of licensure and relationship requirement waivers with out-of-state tele-mental health care, 2019–2021

Koumpias,

Fleming,

Lin

2024

Health Affairs Scholar

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During the COVID-19 public health emergency, states waived in-state licensure and pre-existing patient-physician relationship requirements to increase access to care. We exploit this state telehealth policy variation to estimate the association of in-state licensure requirement waivers and pre-existing patient-physician relationship requirement waivers with out-of-state tele-mental healthcare utilization of patients diagnosed with COVID-19. Using claims from January 2019 till December 2021 of 2,037,977 commercially insured individuals in 3 metropolitan statistical areas (MSA) straddling Midwestern state borders, we find increased out-of-state telehealth utilization as a share of out-of-state mental healthcare by 0.1411 and 0.0575 visits per month or 1,679.76% and 467.48% after licensure and relationship waivers, respectively. Within-MSA analyses illustrate an urban-rural digital divide in out-of-state utilization as a share of total or telehealth mental healthcare. Our findings indicate waivers primarily enhance access to care of established patients by enabling the transition of in-person out-of-state healthcare online. Interstate medical licensure compact participation may provide broader access to out-of-state tele-mental healthcare than emergency waivers.

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Impact Of The New Jersey COVID-19 Temporary Emergency Reciprocity Licensure Program On Health Care Workforce Supply

Cited by 9 publications

References 7 publications

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic

Evolving teledermatology policy and reimbursement landscape in the United States

Association of licensure and relationship requirement waivers with out-of-state tele-mental health care, 2019–2021

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