States can increase capacity by ensuring payment policies encourage providers to deliver the full scope of services, defining scopes as broadly as evidence and good medical practice support, and establishing new provider types to fill specific niches.

*Milestone details:

*Full name: Develop a plan to examine scope of practice and/or provider reimbursement policies to improve access to care.

*Relevance to the ACA:

Though the ACA does not require changes to scope of practice or reimbursement policies, these policies can be tools to achieve the increased health system capacity that will be needed to serve the newly insured. The ACA includes programs to expand the use of ancillary providers.

§5208 – Grants to support Nurse Managed Health Clinics.

§5304 – A demonstration program to train or employ alternative dental health care providers.

§5313 – Grants to promote the use of Community Health Workers.

§5507 – Grants to develop certification programs for personal care aides.

§10321 – Allows non-physician providers to serve as primary care providers on health teams.