An Analytic Approach to Examining the Relationship Between State Scope of Practice Reforms and PA Labor Demand.

Abstract Background State scope of practice (SoP) laws can facilitate or restrict the capacity for PAs to strengthen the health workforce in a state.1Research has found that states with permissive SoP laws increased the PA per population ratio compared to restrictive SoP laws.1Previous analysis of PA job postings data suggests an uneven growth rate across states, even after accounting for population differences.2 The underlying causes of differences in state level demand for PAs and other health care providers, including nurse practitioners (NPs) and physicians, and the extent to which state SoP laws contribute to them, remains uncertain. Our objective is to increase the understanding of the relationship between state SoP laws on PA, NP, and physician job availability by state, specialization, and geographic region. Methods This study will investigate the relationship of state-level PA SoP reforms on PA, NP, and physician job postings between the years 2012-2022. Lightcast data will be utilized for national job postings. Two-way fixed effects regression will be used to identify the marginal effects of SoP reforms on PA, NP, and physician job postings as well as the impact of changes to PA labor demand on NP and physician labor demand. Covariates will include workforce, health care demand and economic proxies. Impact As AAPA and state organizations advocate for OTP, we need to further understand the impact that increasing SoP has on the health care provider workforce. Findings from the study are expected to inform future discussion within the profession involving SoP legislation.