How COVID-19 Emergency Practitioner Licensure Impacted Access to Care: Perceptions of Local and National Stakeholders

Abstract

ABSTRACT The COVID-19 public health emergency required US states to respond rapidly on regulatory issues, including the process for licensing healthcare practitioners. At least 45 states enacted some form of a licensure waiver, enabling practitioners to temporarily work across state lines. We conducted 22 interviews with national and local (New Jersey) licensure stakeholders in September and October 2021 to capture perceptions of how emergency licensure impacted access to care. Five themes emerged: (1) Emergency licensing helped shift the nation’s healthcare workforce supply into regions and specialties of high need; (2) Expanded telehealth capacities complemented emergency licensure programs; (3) Concerns about care quality were mitigated by the urgency of the pandemic, credentialing processes, and investigative authorities; (4) Relocation packages and the need to replace staff could lead to higher costs of care; and (5) Views on licensure reciprocity and interstate compacts were favorable, but smaller provider organizations need to be protected. Overall, stakeholders perceived emergency licensure as successful in expanding access to care during the pandemic. Findings suggest that stakeholders view interstate licensure compacts more favorably now than pre-COVID. While stakeholders may be in favor of licensure reciprocity, they raised concerns about its feasibility, cost, and quality.