This blog post excerpts an article in the Spring 2015 issue of HealthStream's PX Advisor, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.
Several developments in the healthcare industry are resulting in increased demand for primary care services. For one, Baby Boomers have begun turning 65 and are entering the Medicare ranks at a rate of some 10,000 per day. For another, the Affordable Care Act (ACA) is dramatically increasing the numbers of “newly insured,” who are accessing the primary care system with pent up demand for services. The ACA has also spawned new care models, such as accountable care organizations and patient-centered medical homes, which are putting increased focus on primary and preventive care to reduce unnecessary hospital and emergency department usage. Finally, consumers themselves are clamoring for better access and more convenient hours from their primary care providers. Collectively, these trends have resulted in a serious shortage of primary care physicians—as many as 45,000 by 2020—and more intense pressure on states to relax scope of practice requirements and billing limitations for Nurse Practitioners.
Who are nurse practitioners (NPs)?
Nurse practitioners are advanced practice nurses who have achieved levels of education, licensing, and credentialing that far surpass their roles as registered nurses. They have earned Masters or Doctoral Degree in nursing and have the skills necessary to diagnose patients, prescribe treatments and medications, and manage overall care for patients. Nurse Practitioners are subject to national certification, periodic peer review, clinical outcome evaluations, a code for ethical practice, and evidence of continued professional development and maintenance of clinical skills. They are qualified to practice in primary care, acute care, and long-term care settings, although most (88%) choose to practice in the primary care setting. The role of nurse practitioner has been in existence since 1965, and 2015 marks their milestone 50th anniversary year.
What is the demand for nurse practitioners?
The number of nurse practitioners has almost doubled over the past 10 years, going from 106,000 to 205,000 as of Dec. 31, 2014. Even with this growing number of NPs, demand continues to exceed the supply. According to the recruiting firm Merritt Hawkins, the demand for nurse practitioners and physician assistants (PAs) has increased 320% over the past three years. They report that NPs and PAs combined were their fifth most requested placement search, although neither was in the Top 20 three years ago. U.S. News & World Report recently ranked nurse practitioners as the second best overall job of 2015. “The explosive growth of the nurse practitioner profession is a public health boon considering our nation’s skyrocketing demand for high-quality, accessible care,” reports AANP president Ken Miller.
Where is the demand greatest?
The Bureau of Labor Statistics estimates that there will be approximately 37,000 new job openings in the field by 2022. Demand will be greatest in states such as Florida, California, New York, and Texas, where the shortage of primary care physicians is most pronounced.
Although these states have the highest need, primary care shortages are pervasive in the U.S., especially in rural and lower-income areas. In late 2013, according to the U.S. Department of Health and Human Services, there were approximately 5,800 primary care Health Professional Shortage Areas (HPSAs) in the U.S., encompassing some 65 million Americans (Gilman and Koslov, 2014). The Federal Trade Commission comments, “In many areas, these shortages are expected to persist or worsen… it is unclear how the existing population of practitioners can meet this increasing demand.”
This article also addresses:
- What limitations are caused by scope of practice regulations?
- Are quality concerns founded?
- What other challenges do Nurse Practitioners face?
- Where do we go from here?