Increased access to nurse practitioner care in rural Nebraska after removal of required integrated practice agreement

Le Ann R. Holmes, Nancy Waltman

Research output: Contribution to journalArticle


Nebraska is a largely rural state with many communities defined as medically underserved by primary care providers. In 2014, the state legislature voted to eliminate the requirement for an integrated practice agreement (IPA) between nurse practitioners (NPs) and physicians. This report describes changes in access to primary health care in rural and underserved areas of Nebraska after removal of the IPA barrier to practice. The report compares the number of primary care NPs working in medically underserved areas before and after the legislation that ended the required IPA. In addition, anecdotes will be provided of NP and patient experiences in rural, NP-owned practices in Nebraska after IPA requirements were eliminated.

Original languageEnglish (US)
Pages (from-to)288-292
Number of pages5
JournalJournal of the American Association of Nurse Practitioners
Issue number5
StatePublished - May 1 2019


ASJC Scopus subject areas

  • Nursing(all)

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