Trends in US State and Territory Participation in Interstate Healthcare Licensure Compacts (2015-2024)

Background:. Interstate licensure portability has become a significant issue for US healthcare providers. Healthcare compacts have emerged as a promising solution to facilitate interstate licensure portability for many healthcare specialties while maintaining individual state autonomy.Objective:. This study aimed to describe the landscape of interstate healthcare compacts in the US.Methods:. We systematically analyzed compact and legislative websites to determine state-level healthcare licensure compact participation over time.Results:. More healthcare compact bills have been passed over time, as established compacts recruit new states and new compacts emerge. Of the 15 active healthcare compacts identified, all 15 compacts saw the first state/territory to pass compact-specific legislation in at least 1 state/territory in the year of or following the approval of the drafted model legislation. However, the time between when compacts are first discussed to the approval of the drafted model legislation varied considerably between compacts, ranging from 1 year to 20 years. Very few states/territories pass more than 1 or 2 healthcare compact-related bills in any year.Conclusions:. In the last decade, the landscape of interstate healthcare practice has changed dramatically, and state and territory participation in interstate healthcare licensure compacts has expanded over time.