States with the fewest restrictions on nurse practitioners have two-and-a-half times more patients receiving primary care, per a new analysis.

While only 0.2% of Medicare patients nationally used NPs as their primary care provider in 1998, that jumped to 2.9% by 2010, according to researchers at The University of Texas Medical Branch at Galveston.

In looking at a 12-year time period, the highest growth in nurse practitioner primary care was in states that allowed for a larger scope of practice, such as: Alabama, Alaska, Idaho, Maine, Oregon and Vermont. In Alaska, the rate of Medicare patients using an NP as a primary care provider is 15%.

Like other states’ lawmakers, the Texas legislature is evaluating proposed legislation  to eliminate the requirement for on-site physician supervision and allow more leeway in prescribing. 

One reason for expanding NPs’ role: In 1998, more than 60% of medical students pursued primary care; today it is less than 25%. Nursing homes are being pressed to involving nurse practitioners in their facilities and as referral sources.

Results appeared in The Journal of Health Affairs.