COLUMBUS, Ohio (Jan. 28, 2015) – A RAND Health study released today found that removing restrictive scope-of-practice (SOP) laws among Ohio’s Advance Practice Registered Nurses (APRNs) could lead to increased access to health care and approximately 70,000 fewer emergency department (ED) visits in the state, resulting in potential savings for Ohioans due to the high cost of ED visits.

The study, commissioned by the Ohio Association of Advanced Practice Nurses (OAAPN), assessed the impact of removing restrictive SOP laws to allow APRNs to practice to the full extent of their education and training.

Although the report does not directly estimate the financial impact of reductions in ED visits, the impact could be significant.

“We expect the cost savings to be in the millions if we look at the Medicaid and Medicare fee schedules, and compare the cost of ED and primary care visits,” said Diann Nelson-Houser, Immediate Past President of OAAPN. “By granting full practice authority to nurse practitioners and other APRNs, there will be more health care providers available to treat patients in primary care settings, avoiding costly visits to the ED for non-emergency situations.”

APRNs are professionally trained health care providers with a Masters or Doctorate degree who can diagnose patients; treat illnesses; order and interpret tests; and prescribe medication or administer anesthesia. The four types of APRNs include Certified Nurse Practitioners, Certified Nurse Midwives, Clinical Nurse Specialists and Certified Registered Nurse Anesthetists.

The RAND Health study included a literature review and applied the findings to the state of Ohio. Findings included:

  • As many as 1.5 million Ohio residents would potentially report better access to care.
  • Within one to two years of changing the SOP laws, an estimated 330,000 more Ohioans could receive preventive care visits.
  • Nurse practitioners and other APRNs could have increased patient care hours.
  • There could be a decrease in approximately 70,000 ED visits in the state.

The study also highlighted that complying with restrictive SOP requirements is more difficult in areas with fewer potential collaborating physicians, such as rural and underserved communities.

According to the Association of American Medical Colleges, the U.S. will face a shortage of more than 90,000 physicians in 10 years and nearly one-third of physicians will retire in the next decade. Additionally, medical student enrollment in primary care continues to decline and the health care system is experiencing an influx of patients due to an aging population and an increase in insured patients.

Allowing APRNs full practice authority is an increasing trend across the country. More than a third of the states and the District of Columbia allow nurse practitioners and other APRNs to practice autonomously, including prescriptive authority. Research has also shown that the quality of care remains safe and cost-effective.

“Currently, Ohio has some of the strictest SOP laws in the country at a time when we are seeing a shortage in primary care providers and long wait times for patients,” said Nelson-Houser. “APRNs can help fill this gap, but are restricted in the care they provide. This is a disservice to Ohioans. Giving APRNs full practice authority addresses the problem by broadening the pool of qualified health care providers who can treat patients.”

To view the full study results, please visit