Government Report Shows Increase of Nurse Practitioners in Primary Care

After declining for two decades, the rate of recently licensed nurse practitioners (NPs) joining the primary care workforce is moving upward, according to a new report from the Health Resources and Services Administration (HRSA).

According to the National Sample Survey of Nurse Practitioners, in 1992, 59 percent of graduating NPs worked in primary care, but that decreased to 42 percent between 2003 and 2007. The new survey, based on 2012 data, shows that 47 percent NPs who graduated since 2008 have entered primary care, Nurse Zone reports. Survey results also showed:

• 94 percent of that total NP workforce held a graduate degree in some field, 86 percent had a master’s degree in nursing, and 5 percent held a doctoral degree in nursing;
• 76 percent of the NP workforce maintained certification in a primary care specialty (family, adult, pediatric, or gerontology); and
• More than half of the NP workforce worked in ambulatory care settings, with nearly a third practicing in hospitals.

Two recent studies funded by INQRI found significant benefits of NPs working in primary care. The first, led by Joanne Spetz at the University of California, San Francisco, found that increasing use of retail clinics in which nurse practitioners provide primary care and practice independently, can dramatically reduce health care costs, as much as $810 million in 2015, if those clinics account for 10 percent of outpatient primary care visits.

The other, led by David Auerbach of RAND and funded in part by the Donaghue Foundation, found that increasing the number of and the use of models of health care delivery that rely on nurse practitioners or physician assistants as primary care providers could offset the expected primary care physician shortage in 2025.

Are Retail Clinics the Future of Health Care?

In "How Our Faith in Supermarkets, Nurses and Pharmacists Can Drive Health," health economist Jane Sarasohn-Kahn reports that two of the most trusted industries are supermarkets and hospitals and two of the most trusted professions are nursing and pharmacy. She also reports that "who we trust has a huge influence on who we engage for health."

Sarasohn-Kahn posits that this confluence will mean that self-care, particularly using retail clinics and seeking healthy products and advice in retail settings will become increasingly important and may be the best major drivers of health in our nation.

Her conclusion dovetails with the findings two studies funded by INQRI and published in Health Affairs earlier this year. One, led by Joanne Spetz at the University of Cailfornia, San Francisco, found that increasing use of retail clinics in which nurse practitioners provide primary care and practice independently, can dramatically reduce health care costs - by as much as $810 million in 2015, if those clinics account for 10 percent of outpatient primary care visits.

The other, led by David Auerbach of RAND and funded in part by the Donaghue Foundation, found that increasing the number of and the use of models of health care delivery that rely on nurse practitioners or physician assistants as primary care providers could offset the expected primary care physician shortage in 2025.

One thing is certain, there are many options for expanding access to health care and serious thought must be given to increasing the use of nurse practitioners and physician assistants as primary care providers in a range of settings.