Tuesday, 17 August 2021 14:11

OPINION: Amid resurgent pandemic, North Carolina must SAVE health care access

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Health care comes at a premium for many North Carolinians who wait weeks for appointments, travel miles to see a clinician and endure costly inefficiencies and inequities within the health care system. As a nurse practitioner, I’ve seen firsthand the effects of our state’s outdated health workforce laws ― patients suffering from preventable and chronic disease conditions worsened by inadequate access to care. The good news is there’s a no-cost, no-delay solution to this problem. It’s time to pass the SAVE Act (H.B. 277/S.B. 249), which is pending before our state legislature.


North Carolinians need increased health care access ― the top issue for 71% of Americans, according to a recent Kaiser Family Foundation poll. In 2019, North Carolina was a shocking 36th overall in America’s Health Rankings. Even more alarming, there are 186 primary care health professional shortage areas in our state, affecting more than 2 million people and leaving at least half the state’s health care access needs unmet.

With more than 7,000 NPs licensed across North Carolina ― nearly 90% prepared in primary care ― NPs are well-positioned to help meet our growing health care challenges. Currently, legal authority for NPs to practice in the state is conditional upon antiquated collaborative agreements with physicians. This outdated requirement costs the state in reduced health outcomes ― and real dollars.

Over the last 18 months, our nation — and particularly the Tar Heel state — has faced extreme challenges due to the COVID-19 pandemic. The ongoing health crisis has shined a bright light on the disparities existing in health care access, which NPs have worked long and hard to address across urban, suburban and rural communities, especially here in North Carolina. States that modernized their laws prior to the pandemic responded to the crisis more effectively than North Carolina and others that did not. This extends not only to COVID-19, but to hurricane response and other emergencies where access to care is a priority. Like other states that have provided full and direct access to NP care for decades, both Massachusetts and Delaware have recently adopted legislation to do the same — recognizing that patients in nearly half of all U.S. states have benefited from increased access to NP-delivered care.

Today, North Carolina remains among the more heavily regulated states for NPs, but our health care crisis can be alleviated by removing barriers that increase costs, restrict choice and impede access. Research shows states that have adopted elements of the SAVE Act have improved health care access, decreased rebound hospitalizations and achieved cost savings by mainlining quality care. To date, 24 states and the District of Columbia have modernized their laws, and patients in those states can directly access NPs who diagnose, treat, prescribe medications and manage health care needs.

The SAVE Act right-sizes decades-old health workforce laws and will safely expand the availability of NP-delivered care to address our state’s growing health care demand. With nearly 11,000 new cases of COVID-19 diagnosed over the last weekend and close to 2,000 patients hospitalized across the state as of Monday, I call on our legislature to pass and our governor to sign the SAVE Act for a cost-effective solution that will increase the accessibility of quality health care for all North Carolinians by ensuring patients have full and direct access to the health care provider of their choice.

Frank Manole, DNP, MSN, MBA, ACNP-BC, FAANP, is a nurse practitioner in Raleigh, North Carolina and a Board Member for the American Association of Nurse Practitioners.