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Rural Health
Resources by Topic: Scope of practice

How Actual Practice of Emergency Medical Services Personnel Aligns with the Recommended National Scope of Practice in Rural Versus Urban Areas of the U.S.
Results of a study examining the extent to which EMS professionals perform skills that correspond to their credential levels, and determining whether there are variations in adherence to guidelines between agencies serving rural or urban populations and agencies with unpaid versus paid staffing models. Examines credentials for emergency medical responders, emergency medical technicians (EMTs), advanced EMTs, and paramedics, and uses data from EMS encounters in 2018 from 1,056 EMS agencies nationally. Features statistics on various procedures and predictors of performing a procedure within the scope of practice model, with breakdowns by 4 levels of population density.
Author(s): Davis G. Patterson, Benjamin A. Stubbs, Nikiah G. Nudell
Date: 02/2022
Sponsoring organization: UW Center for Health Workforce Studies
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How States Can Expand Health Care Access in Rural Communities
Discusses policy options states could use to increase access to care and the supply of healthcare providers in rural areas. Covers financial assistance programs for medical and dental education; malpractice reform; scope of practice changes for advanced practice registered nurses, physician assistants, and dental health aide therapists; telemedicine parity; and mobile clinics.
Date: 02/2022
Sponsoring organization: Center for American Progress
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The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature
Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Sponsoring organization: Milbank Memorial Fund
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Expanding Pharmacists' Prescriptive Authority: Options for Reform
Explores why states may want to consider expanding pharmacists' prescriptive authority. Presents state policy options for expanding prescriptive authority for pharmacists, including advantages and disadvantages of each and examples from states. Also addresses potential concerns about the increased prescriptive authority of pharmacists.
Author(s): James Broughel, Elise Amez-Droz
Date: 12/2021
Sponsoring organization: Mercatus Center
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Relationship Between Population Density and Scope of Practice for Certified Registered Nurse Anesthetists in Arizona
Study surveyed 230 Certified Registered Nurse Anesthetists (CRNA) in Arizona to compare scope of practice and population density as well as scope of practice and job satisfaction. Discusses regulations and barriers in scope of practice for CRNAs and other healthcare professionals nationally in the context of recruitment and retention.
Author(s): Michael A. MacKinnon
Citation: AANA Journal, 89(4), 325-333
Date: 08/2021
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Primary Care in the United States: A Chartbook of Facts and Statistics
Examines aspects of primary care in the United States, including facts and figures on patient contact with primary care, frequency and range of conditions seen in primary care, care coordination, scope of practice, payment models, and preventive care visit utilization. Features statistics on percentage of primary care physicians by geography, with breakdowns by urban, large rural, small rural, and isolated rural location.
Author(s): Brian Antono, Andrew Bazemore, Irene Dankwa-Mullan, et al.
Date: 02/2021
Sponsoring organization: Robert Graham Center
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Improving Rural Health: State Policy Options for Increasing Access to Care
Discusses strategies from state legislatures and other stakeholders to increase access to healthcare in rural areas. Focuses on policies and policy options for state legislatures in three areas: improving health insurance coverage, safeguarding rural health facilities, and changing rural healthcare delivery. Features examples from Colorado, Georgia, Pennsylvania, and Wisconsin.
Author(s): Jack Pitsor
Date: 06/2020
Sponsoring organization: National Conference of State Legislatures
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The Respiratory Therapist Workforce in the U.S.: Supply, Distribution, Education Pathways, and State Responses to Emergency Surges in Demand
An overview of the respiratory therapist workforce across the U.S. including their practice scope and settings, supply and distribution, education and credentialing, and work force capacity with an additional focus on the emergency related concerns of COVID-19.
Author(s): Susan M Skillman, Bianca K Frogner, Arati Dahal, Benjamin A Stubbs, Grace Guenther
Date: 04/2020
Sponsoring organization: UW Center for Health Workforce Studies
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The Behavioral Health Workforce in Rural America: Developing a National Recruitment Strategy
Describes successful strategies to recruit and retain behavioral health workers in rural areas, based on phone interviews with state-level experts in rural health and behavioral health. Explores financial incentives, education and training programs, telehealth, licensure or scope of practice changes, innovative state approaches, and policy considerations.
Author(s): Nancy Baum, Jaque King
Date: 02/2020
Sponsoring organization: Center for Health and Research Transformation
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Health Disparities in Rural America: Current Challenges and Future Solutions
Describes health risks experienced by rural people and the problems they face in accessing healthcare in shortage areas, and offers possible solutions. Includes a map showing Primary Care Health Professional Shortage Areas by county, and a list of states allowing full practice authority for nurse practitioners as of 2019.
Author(s): Theresa Capriotti, Tiffany Pearson, Lillian Dufour
Date: 02/2020
Sponsoring organization: Clinical Advisor
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