Will interstate compacts turn into national licensure?

Whether you’re in Maine or Hawaii, Florida or Alaska, all people deserve the same high-quality healthcare.

So, shouldn’t the quality standards for the physicians, nurses and other healthcare professionals – who provide patient care – be the same no matter where you live?

In the past, each state developed and promulgated its own standards for healthcare professionals through state boards. But today, a national movement is underway to establish interstate compacts that could eventually lead to nationwide licensure instead of state-by-state. While the path to that goal will still take years, there is growing recognition that national licensure would be a big improvement for patients, patient care facilities and healthcare professionals themselves.

To begin, there’s no evidence that healthcare professionals in one state are better or worse than in other states. Yet, in most parts of the country, healthcare professionals who can commute to several states in an hour or two must have separate licenses to work in each state. For example, if you live anywhere in the New York metropolitan area, you must have separate licenses to practice in Connecticut, New York, New Jersey or Pennsylvania, even though you could commute to those states to pick up shifts or take patients in an hour or two – or much less time.

Nurses, Physicians, PT & APRNs
In the interstate compact movement, nursing is way ahead of other professions. If you qualify for the Nurse Licensure Compact, you can practice in all 31 compact states. It’s the only true multistate license.

The physician compact includes 24 states so far. However, under the medical licensure compact, applicants must apply separately for multistate privileges and pay for individual licenses in each state.

For physical therapists and physical therapist assistants, if you meet all the requirements in a compact state, you can purchase compact privileges in other compact states. So far, only six states accept compact privileges, but more than a dozen other states have enacted.

A model for an interstate Advanced Practice Nurse Compact recently began and will be implemented when ten states have enacted legislation. For all other healthcare professions, licensure is strictly state by state.

Is National Licensure in Our Future?
The growing interstate licensure movement should gain steam as more states join in and as health systems and healthcare professionals advocate for a simpler, more cost-effective licensing system. Greater flexibility for clinicians and providers, improved patient access to care, and reduction in costs and redundancy will prove to be strong arguments in state legislatures considering licensure compact legislation. State lines will no longer block telemedicine. Underserved areas in rural and urban areas will be able to draw upon more healthcare professionals. As more and more states join in, national licensure will become inevitable.

National licensure has so many positives, you might ask where the opposition comes from. Not from healthcare professionals themselves. A 2017 survey of registered nurses by AMN Healthcare found that 68% supported national licensing instead of state-by-state, and among Millennial nurses, 77% supported it. Instead, resistance to this change is probably just the inertia of bureaucracy. Plus, passing state-by-state legislation on anything is a cumbersome process.

In the conversation about the evolution of healthcare in the United States, and particularly the movement to value-based care, interstate compacts -- and eventually national licensure for all healthcare professionals -- should be an important factor. It’s win-win for all involved – especially the patient.

READ MORE:
Strong Support for National Nurse Licensure, Especially Among Millennials
AMN Launches Campaign to Help PT Professionals Seeking Multistate Privileges
Practicing Across State Lines is Getting Easier for Physicians

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