Number of nurse practitioners expected to double by 2025

New, efficient care models require midlevel provider support

The number of nurse practitioners (NPs) in the United States is expected to increase from 128,000 in 2008 to 244,000 in 2025, according to a RAND Corp analysis published in Medical Care.

For the analysis, RAND health economist David Auerbach applied National Sample Survey of Registered Nurses data from 1992 to 2008 to an age-cohort regression-based model. The model projected a 94% increase in the number of individuals trained to be NPs over the 17-year period.

Auerbach's analysis also indicates that the number of NPs that provide direct patient care, as opposed to those completing more administrative tasks, will increase by 130%, from 86,000 in 2008 to 198,000 in 2025.

Auerbach's findings mirror other research on midlevel provider growth patterns. For example, the American Academy of Physician Assistants' annual census found that the number of physician assistants (PAs) increased from 40,469 in 2000 to 83,466 in 2010, a 106% increase. Meanwhile, a 2011 CDC release found that 49% of office-based physicians work with Pas, NPs, or certified nurse midwives.

According to health workforce experts, midlevel providers are becoming more common as the U.S. health system looks to more efficiently utilize physicians amid shortages. In addition, they say that midlevel providers will help meet the increased medical demands of the aging U.S. population.

At the same time, Auerbach notes that "new health care models such as the patient-centered home and accountable care organizations really depend on [NPs] and [PAs]."

Many physician organizations, including the American Medical Association, support the integration of NPs and PAs into care teams. However, they say that midlevel providers should operate with physician supervision or collaboration (Stagg Elliot, American Medical News, 7/2).

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