Realizing Full Value of the Care Team

Strategically Deploying Advanced Practitioners to Expand Access and Coordinate Care

This study offers strategies for designing advanced practitioner clinical roles, strengthening physician-advanced practitioner collaboration, and managing the advanced practitioner cohort.

Executive Summary

Redefine AP roles to boost autonomy

APs can enable medical groups to cost-effectively increase patient access and care quality in spite of physician shortages—but only if groups rethink AP and physician roles.

Instead of merely supporting a physician’s workflow, APs should assume more autonomous clinical functions and see patients independently. Physicians, in turn, must focus on patients who need a higher level of clinical expertise. We have identified several best practice models for sharing work in this way across specialty, inpatient-based, and primary care practice.



Strengthen the AP-physician relationship

As APs assume more autonomous clinical roles, medical groups must lay strong foundations for AP-physician collaboration.

Effective deployment is the first step to appropriate AP utilization. Physicians aren’t always familiar with APs’ capabilities, leading to staffing requests that don’t necessarily reflect actual practice needs. This study profiles medical groups that have created robust processes for evaluating, supporting, and monitoring AP placements.

The AP-physician relationship is equally important. Most physicians haven’t been taught to work effectively in a team, and many are rightly skeptical of AP clinical training.

Medical groups are overcoming these challenges by supporting physicians in an AP oversight role and elevating AP clinical preparation. For instance, groups are creating workshops that teach physician leaders how and when to rely on APs, assigning seasoned mentors to physicians just beginning to work with APs, and drafting formal supervision arrangements. Others are working to equalize clinical experience across the AP workforce through mentorships and robust AP residency programs.

In addition, compensation incentives for both APs and physicians can help hardwire cooperation. An ideal AP incentive model rewards individual success and progress toward group goals. Physicians, especially PCPs, should be rewarded for high AP performance to counteract provider competition.

AP management should reflect the AP role

APs function more like physicians than any other type of clinical staff, but management structures often lump APs together with support staff. This not only denies APs important privileges but also shields them from accountability.

To manage the AP workforce to its fullest, progressive medical groups are centralizing oversight of AP hiring within the medical group and establishing contracts and performance evaluation processes that closely match those used for physicians. Some are even designating a dedicated AP leader to address APs' unique role and needs.

In this study, members will find:

  • Models for AP utilization
  • Approaches to AP clinical education
  • Tools for structuring AP deployment, performance evaluation, and clinical training
  • Incentives for physicians and APs that support collaboration
  • Example management structures for APs

Redefine AP roles to boost autonomy

APs can enable medical groups to cost-effectively increase patient access and care quality in spite of physician shortages—but only if groups rethink AP and physician roles.

Instead of merely supporting a physician’s workflow, APs should assume more autonomous clinical functions and see patients independently. Physicians, in turn, must focus on patients who need a higher level of clinical expertise. We have identified several best practice models for sharing work in this way across specialty, inpatient-based, and primary care practice.



Strengthen the AP-physician relationship

As APs assume more autonomous clinical roles, medical groups must lay strong foundations for AP-physician collaboration.

Effective deployment is the first step to appropriate AP utilization. Physicians aren’t always familiar with APs’ capabilities, leading to staffing requests that don’t necessarily reflect actual practice needs. This study profiles medical groups that have created robust processes for evaluating, supporting, and monitoring AP placements.

The AP-physician relationship is equally important. Most physicians haven’t been taught to work effectively in a team, and many are rightly skeptical of AP clinical training.

Medical groups are overcoming these challenges by supporting physicians in an AP oversight role and elevating AP clinical preparation. For instance, groups are creating workshops that teach physician leaders how and when to rely on APs, assigning seasoned mentors to physicians just beginning to work with APs, and drafting formal supervision arrangements. Others are working to equalize clinical experience across the AP workforce through mentorships and robust AP residency programs.

In addition, compensation incentives for both APs and physicians can help hardwire cooperation. An ideal AP incentive model rewards individual success and progress toward group goals. Physicians, especially PCPs, should be rewarded for high AP performance to counteract provider competition.

AP management should reflect the AP role

APs function more like physicians than any other type of clinical staff, but management structures often lump APs together with support staff. This not only denies APs important privileges but also shields them from accountability.

To manage the AP workforce to its fullest, progressive medical groups are centralizing oversight of AP hiring within the medical group and establishing contracts and performance evaluation processes that closely match those used for physicians. Some are even designating a dedicated AP leader to address APs' unique role and needs.