How Many Nurse Practitioners Provide Primary Care? It Depends On How You Count Them

Spetz, Joanne; Fraher, Erin; Li, Yin; Bates, Timothy C.

doi:10.1177/1077558715579868

Cited by 26 publications

(39 citation statements)

References 25 publications

(35 reference statements)

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“…For NPs in 2014, an estimated 6% of active licenses in the nation were duplicates because NPs were licensed in more than one state (unpublished data from AANP). Whether both licenses were in effect was not assessed but one report identified conundrums in understanding the number and geographical distribution of primary care NPs in two states (Spetz, Fraher, Li, & Bates, ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of nurse practitioners and physician assistants in the United States

Hooker

Brock

Cook

2016

Journal of the American Association of Nurse Practitioners

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Background Nurse practitioners (NP) and physician assistants (PA) serve as independent or semiautonomous providers and as fundamental members of healthcare teams. Purpose Differentiating roles of health professionals is needed for optimal employment utilization. Clinically practicing PAs and NPs were characterized. Methodology Data included wage and workforce projections to 2022.Variables included number practicing, age, gender, race, ethnicity, education, principal employer, practice specialty, and wages. Results Health delivery establishments employed 88,110 PA and 113,370 NP clinicians in 2013. Both were predominantly female: NPs were older (49 years) on average than PAs (38 years). A significant number of them practiced in physicians’ offices or in acute care hospitals. Median wages were at parity. Growth predictions from 2012 to 2022 were 31%–35%. Conclusions PAs and NPs constitute 20% of the composite clinician labor force (MD, DO, PA, NP). Labor market analysis suggests they are in demand. A majority of NPs and a third of PAs work in primary care fields. Their collective projected growth suggests a solution to emerging workforce shortages and an ability to help meet healthcare demands. Implications for practice Adaptability to changing roles, especially in primary care and underserved areas, makes them facile responders to market demands in a continuously evolving healthcare environment.

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Section: Discussionmentioning

confidence: 99%

Characteristics of nurse practitioners and physician assistants in the United States

Hooker

Brock

Cook

2016

Journal of the American Association of Nurse Practitioners

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“…In addition, reviewed studies on NP workforce did not specify NP clinical specialty (i.e., primary care or specialty care). Recent evidence has shown that at least half of NPs did not practice in primary care and instead were in specialty clinical fields (Spetz, Fraher, Li, & Bates, 2015; U.S. Department of Health and Human Services, Health Resources and Services Administration, & National Center for Health Workforce Analysis, 2014). To better understand the role of NPs in health care delivery, it is important that future studies differentiate NP primary care and specialty care practice, thus providing more fine-tuned evidence to inform health care policy.…”

Section: Limitationsmentioning

confidence: 99%

Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review

et al. 2016

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a b s t r a c tBackground: One proposed strategy to expand primary care capacity is to use nurse practitioners (NPs) more effectively in health care delivery. However, the ability of NPs to provide care to the fullest extent of their education is moderated by state scope-of-practice (SOP) regulations. Purpose: The purpose of this study was to examine the impact of state SOP regulations on the following three key issues: (a) NP workforce, (b) access to care and health care utilization, and (c) health care costs. Methods: Systematic review. Results/Discussion: States granting NPs greater SOP authority tend to exhibit an increase in the number and growth of NPs, greater care provision by NPs, and expanded health care utilization, especially among rural and vulnerable populations. Our review indicates that expanded NP practice regulation can impact health care delivery by increasing the number of NPs in combination with easing restrictions on their SOP. Conclusions: Findings show promise that removing restrictions on NP SOP regulations could be a viable and effective strategy to increase primary care capacity.

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“…These data sources tend to underestimate the number of practicing NPs (Spetz, Fraher, Li, & Bates, 2015) because NPs may not always bill directly (Kaplan et al, 2012), and there are nurses who are licensed or certified as NPs but may not be working as an NP (e.g., they may work in a registered nurse role; HRSA, 2014). …”

Section: Conceptual Basis For the Studymentioning

confidence: 99%

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

et al. 2016

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Increasing patient demand following health care reform has led to concerns about provider shortages, particularly in primary care and for Medicaid patients. Nurse practitioners (NPs) represent a potential solution to meeting demand. However, varying state scope of practice regulations and Medicaid reimbursement rates may limit efficient distribution of NPs. Using a national sample of 252,657 ambulatory practices, we examined the effect of state policies on NP employment in primary care and practice Medicaid acceptance. NPs had 13% higher odds of working in primary care in states with full scope of practice; those odds increased to 20% if the state also reimbursed NPs at 100% of the physician Medicaid fee-for-service rate. Furthermore, in states with 100% Medicaid reimbursement, practices with NPs had 23% higher odds of accepting Medicaid than practices without NPs. Removing scope of practice restrictions and increasing Medicaid reimbursement may increase NP participation in primary care and practice Medicaid acceptance.

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How Many Nurse Practitioners Provide Primary Care? It Depends On How You Count Them

Cited by 26 publications

References 25 publications

Characteristics of nurse practitioners and physician assistants in the United States

Characteristics of nurse practitioners and physician assistants in the United States

Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

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