As health care costs remain a top concern for North Carolinians, some nursing advocates suggest that changing current law related to the patient care team would reduce costs. However, available data indicate the opposite: reducing physician involvement can increase utilization and drive higher overall health care spending.
Proposals such as HB 514/SB 537 (APRN Definitions/SAVE Act) would significantly alter North Carolina’s current care model by reducing or eliminating physician involvement in key aspects of patient care. These changes may lead to unintended consequences for both cost and quality.
Research consistently shows that care delivered without appropriate physician oversight is associated with increased use of services:
- A study published in the Journal of General Internal Medicine found that nurse practitioners were 20 times more likely to overprescribe opioids in states with fewer prescribing restrictions.
- X-ray ordering increased by more than 400% among non-physicians, contributing to higher costs and unnecessary patient exposure.
- In dermatology, non-physician providers required approximately twice as many biopsies to screen for skin cancer.
- Patients treated by non-physicians were 15% more likely to receive antibiotics, adding to costs and contributing to antibiotic resistance.
These patterns reflect a broader concern: higher utilization does not equal higher-value care. When additional tests, procedures, and prescriptions are used unnecessarily, costs increase without improving outcomes.