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Policy, Politics, & Nursing Practice
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Insurers’ Contracting Policies on Nurse Practitioners as Primary Care Providers: The Current Landscape and What Needs to Change

Tine Hansen-Turton, BA, MGA

National Nursing Centers Consortium in Philadelphia, Pennsylvania

Ann Ritter, BA, JD

National Nursing Centers Consortium in Philadelphia, Pennsylvania

Heather Begun, BA

University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania

Sandra L. Berkowitz, RN, JD

National Nursing Centers Consortium in Philadelphia, Pennsylvania

Nancy Rothman, EdD, RN

Department of Nursing, College of Health Professions, Temple University, Philadelphia, Pennsylvania

Brian Valdez, BA, JD

National Nursing Centers Consortium in Philadelphia, Pennsylvania

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.

Key Words: nurse-managed health centers • managed care • provider credentialing • provider contracting

Policy, Politics, & Nursing Practice, Vol. 7, No. 3, 216-226 (2006)
DOI: 10.1177/1527154406294339
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