May 1, 2026
The following op-ed was originally published by The Carolina Journal. Click here to read it in its entirety.
North Carolina’s health care access challenges are not theoretical — they are showing up in real ways across the state, particularly in rural communities where provider shortages and rising costs are putting increasing strain on patients, employers, and local economies.
Patients are traveling longer distances, waiting weeks for appointments, and in some cases delaying care altogether. Employers, meanwhile, are absorbing significant increases in health care costs while trying to maintain a stable workforce.
That reality is now being acknowledged by providers themselves. Washington Regional Medical Center, a 25-bed critical access hospital serving multiple counties in eastern North Carolina, recently stepped forward in support of reforming regulations on Advanced Practice Registered Nurse (APRN) — as a way to strengthen access and better meet community needs.
This is not an isolated case — it reflects a broader structural issue.
While much of the conversation has focused on provider shortages, an equally important question is whether North Carolina is making full use of the health care workforce it already has.
APRNs — including nurse practitioners and certified nurse midwives — are highly trained, nationally certified professionals who are already delivering high-quality care across the state. Yet outdated regulatory requirements continue to limit how that care can be delivered in practice.
Maximizing APRNs would not require new programs or new spending. Instead, it would simply allow existing providers to practice to the full extent of their education — expanding access, reducing delays, and improving system efficiency.
This is a proven approach. Twenty-seven states and Washington, DC, have already adopted similar models, and North Carolina itself implemented temporary flexibility during the COVID-19 pandemic and recent disaster response efforts without any increase in complaints or safety concerns.
There is also a clear economic case. Analysis from a Duke health economist estimates that modernizing APRN regulations could generate at least $900 million in annual savings, with the potential for significantly greater impact over time.
For policymakers, this represents a practical, supply-side solution — one that addresses access, cost, and workforce capacity without expanding government or adding new burdens to the system.
It is not a silver bullet. But it is a clear, evidence-based, and effective step that can be taken now.
As the General Assembly considers how best to strengthen both North Carolina’s health care system and its economy, this is a solution that is long overdue.
Additional information and data on APRN full practice authority are available at https://ncfpa.info/.
Tina C. Gordon, CEO of the North Carolina Nurses Association
MEDIA CONTACT
Chris Cowperthwaite, CAE, APR
Director of Communications & Outreach
(919) 821-4250 or chriscowperthwaite@ncnurses.org.
ABOUT NCNA
As the leading professional organization for North Carolina’s registered nurses, we equip nurses at all stages to thrive in an ever-changing healthcare environment. NCNA helps keep North Carolina nurses on the cutting edge of nursing practice, policy, education, and more. Join us as we work to advance nursing and ensure high-quality healthcare for everyone.
Established in 1902, NCNA provides continuing education, networking and legislative advocacy for registered nurses throughout North Carolina. For more information, please visit www.ncnurses.org.
MISSION STATEMENT
The North Carolina Nurses Association serves the changing needs of its members, addresses nursing issues, and advocates for the health and well-being of all people.
