Fighting for Health Care Access
Fighting for Health Care Access
Rural Communities Are Running Out of Access
More than 80 of Tennessee’s 95 counties are designated Health Professional Shortage Areas. Patients wait weeks or months for appointments, travel long distances for basic care, or rely on emergency departments for routine needs.
This is not a future concern. It is happening now across rural Tennessee.
The Workforce Already
Exists
APRNs and PAs are already practicing across Tennessee, particularly in rural and underserved communities. They provide primary care, manage chronic disease, and sustain access in clinics and hospitals that would otherwise struggle to remain open.
The barrier to care is not training or competence.
It is outdated law.
A Moment for
ACTion
Tennessee’s $200 million Rural Health Transformation Program award recognizes that workforce flexibility is essential to rebuilding rural health infrastructure.
Governor Bill Lee’s call to modernize scope of practice laws reflects an evidence-based approach focused on access, outcomes, and community stability.
Now is the time to align law with reality.

Rural Tennessee faces growing access challenges driven by provider shortages, long travel distances, and overreliance on emergency departments for routine care.
These challenges are not caused by a lack of qualified clinicians. They are the result of outdated policies that limit how care can be delivered, even when providers are already serving these communities.

Modernizing scope of practice laws allows APRNs and PAs to work to the full extent of their education and training.
Evidence from more than half of U.S. states shows this approach:
• Expands access to care
• Improves rural recruitment and retention
• Maintains patient safety and quality
• Strengthens healthcare system sustainability
TN RHTF Application Full Document (pdf)
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“We have not seen research suggesting that the safety or quality of primary care services declines when APRN supervision or collaborative practice requirements are lessened or eliminated.”

“Among the quality of care components that these studies measure are several process measures, among them patient’s satisfaction, time spent with patients, prescribing accuracy, and the provision of preventive education. In each of these categories, Nurse Practitioners provided at least equal quality of care to patients as compared to physicians.”

Future of Nursing Report:
“The contention that APRNs are less able than physicians to deliver care that is safe, effective and efficient is not supported by the decades of research that has examined this question.”

"We have reviewed sizable body of evidence related to whether there was any difference in quality of care when it was provided by APRNs rather than physicians. There is extensive empirical evidence that APRN practice outcomes are at least equivalent to those of physicians to which they are compared. And on some metrics, such as patient satisfaction, some studies have found APRN care is actually better."

“When physician groups argue to restrict the scope of practice of nurse practitioners, they argue that a broader scope of practice would threaten patient safety. Yet study after study has shown midlevel clinicians provide a level of quality equal to that of physicians performing the same services.”
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