Demand for NPs Just Keeps Growing

As nurse practitioners celebrate their profession during the week of November 7-13, they can bask in the knowledge that NPs are more valued than ever – and that the future for their profession looks bright.

Trends such as the need to provide patients greater access to care and team-based care delivery are raising the prospects for NPs to levels that perhaps have never before been seen.

Such demand is reflected in a recent study from healthcare search and consulting firm Merritt Hawkins. For the first time in 28 years, NPs topped the list of the firm’s most requested search engagements. In the 27 previous years, the top position always has been held by physicians, notes the 2021 Review of Physician and Advanced Practitioner Recruiting Incentives.

In 2015-16, Merritt Hawkins counted 150 NP recruiting engagements. By 2020-21, that number had more than doubled, to 335 engagements.

Some 18% of Merritt Hawkins’ search assignments were for advanced practitioners, including NPs, physician assistants (PAs) and certified registered nurse anesthetists (CRNAs), up from 13% the previous year, the study notes. This is the highest percentage in the 28 years the Review has been conducted.

What’s more, average starting salaries for NPs grew notably, from $125,000 in 2019-2020 to $140,000 – a 12% increase, according to the study. That’s significantly higher than the $117,000 average starting salary in 2015-16.

The Review is based on a representative sample of the 2,458 permanent physician and advanced practitioner search assignments Merritt Hawkins/AMN Healthcare’s physician staffing companies had ongoing or were engaged to conduct during the 12-month period from April 1, 2020 to March 31, 2021. During this time, the study notes, the dynamics of the physician recruiting market were atypical due to the pandemic.

Access a big factor

April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN

Providing greater access to care is one major trend driving the demand for NPs. Nurses are returning to school to get the advanced education needed to practice as an NP, according to April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of the American Association of Nurse Practitioners (AANP).

“Why are they doing that? Because we have a significant problem in our country in terms of access to care,” Kapu said in an interview. “Over 80 million Americans lack access to care. And so we’re seeing nurse practitioners really stepping up to help meet that demand and meet that need. They’re increasingly moving to rural areas to provide care in communities that have historically been provider-shortage communities.”

Today, over 325,000 NPs are licensed in the U.S., up from about 270,000 in 2018-2019, she noted. Over 36,000 new NPs completed their academic programs in 2019-2020, according to a fact sheet from the AANP.

Patients desire quick, easy access to care, noted Michael Belkin, JD, FACHE, CMPE, the divisional vice president of Merritt Hawkins. This need “really speaks to leveraging advanced practice providers” in a team-based care model.

Prior to the pandemic, he noted, trends driving healthcare included value-based care, population health, and telemedicine, among others. “Then COVID hit and all those conversations have been accelerated.”

Team-based and value-based care models include NPs, noted Belkin. “The physician is not the center of the universe when it comes delivering patient care. It’s everyone working to the tops of their license.”

Full practice authority

Michael Belkin, JD, FACHE, CMPE, divisional VP, Merritt Hawkins

NPs also benefit from the full practice authority provided in various states, where the licensure authority allows them to practice to the full extent of their education and training, according to Kapu. Currently, she noted, 24 states and the District of Columbia grant full practice authority. “In those states, we’re seeing nurse practitioners moving out to rural communities because they don’t have the red tape or the restrictions, so to speak, that the non-full practice authority states have,” she said.

“We see more states authorizing more autonomy,” said Belkin. “More and more states are opening up the breadth that a nurse practitioner can work in, independently managing her own patient panel, not having to have any type of supervision, either direct or indirect. That seems to be expanding.”

In addition, primary care physicians are still in short supply, noted Belkin. “The value of a nurse practitioner/PA is great and the cost of bringing them on is significantly less,” he said.

Demand to continue

“I think the biggest takeaway is that this isn’t something that happened overnight,” said Belkin.

Over the last decade, he noted, team-based care, with each provider working to the top of his or her license, happened in various pockets across the country. The pandemic accelerated that trend.

“It also helps the patient be more involved in preventative care because this type of provider can spend more time with them about education and best practices in preventative care. I don’t see why this would go anywhere but continue going north at a relatively good speed.”