Upon implementation of the Affordable Care Act (ACA), many managed care organizations (MCOs) initially increased their nurse practitioner (NP) contracting. This trend has not continued, potentially frustrating ACA efforts to expand primary care provider capacity. In this study, about 25% of the responding MCOs did not contract with NPs as primary care providers. only 62.5% of respondent MCOs offering Medicaid products reported contracting with NPs as primary care providers, suggesting this will place a disproportionate burden on low-income patients seeking to access care. Findings from this study also have important geographic implications, suggesting the decision to contract with NPs is made individually, not necessarily influenced by the numbers of newly insured or available primary care physicians.

中文翻译：

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与管理式护理组织签约仍然对护士执业者构成障碍吗？

在实施《负担得起的护理法案》（ACA）之后，许多管理式护理组织（MCO）最初都增加了其执业护士（NP）合同。这种趋势没有持续下去，有可能使ACA努力扩大初级保健提供者的能力。在这项研究中，约有25％的MCO没有与NP作为初级保健提供者签约。提供医疗补助产品的受访MCO中，只有62.5％的人报告与NPs签约，成为初级保健提供者，这表明这将给寻求获得护理的低收入患者带来不成比例的负担。这项研究的发现还具有重要的地理意义，表明与NP签约的决定是单独做出的，不一定受新保险或可用的初级保健医师人数的影响。