Nurse practitioner race and ethnicity and interest in independent primary care practice and serving Medicaid enrollees

Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to practice without formal supervision after 3 years of practice and without any physician relationship after 5 years of practice. This study used data from a representative survey of California-licensed NPs fielded in late 2022 to examine NPs' current practice and intentions following implementation of the new regulations. Results indicated notable differences in the characteristics of NPs who are considering establishing an independent primary care practice and who are considering changing their practice to serve more Medicaid enrollees at the advent of expanded scope of practice. The strong association between racial/ethnic identity and greater interest in practice change suggests that after the elimination of physician collaboration requirements, increasing the diversity of the NP workforce may be one of the most important strategies for increasing access to care for Californians and especially for people receiving Medicaid.