Advanced practice providers fill capacity gaps amid continued scope-of-practice debates

Editor's Note

A recent report in Becker’s Hospital Review illuminated health systems’ efforts to address physician shortage by integrating advanced practice providers (APPs) into care models.

Citing projections from the Bureau of Labor Statistics (BLS), Becker’s noted that nurse practitioners (NPs) “are the fastest-growing occupation in the country, with employment in the profession expected to grow 46% by 2031. Physician assistant employment is also slated to increase nearly 30% in the same time period, placing it among the nation's 20 fastest-growing occupations.” APPs also include certified registered nurse anesthetists (CRNAS).

In surgery, APPs can facilitate faster pre- and post-operative access, allowing surgeons to focus on procedures while ensuring continuity of care, James Kravec, MD, chief clinical officer of Bon Secours Mercy Health's Youngstown/Lorain Ohio Market, told Becker's. Systems such as Sentara Health and Bon Secours Mercy Health are leveraging APPs to enhance patient care through team-based models. At Sentara, transitioning from 1-to-1 physician-APP pairings to broader care teams has expanded capacity while maintaining quality. APPs in primary care at Sentara now manage approximately 1,100 patients annually, compared to 1,500 for physicians.

Citing a Kaufman Hall analysis, the outlet reports that over 60% of new healthcare providers entering the workforce in 2020 were APPs, compared to 37% who were physicians. However, scope-of-practice debates persist even amid growing integration of APPs, Becker’s reports. For example, the American Medical Association warns that independent APP practice could harm patient outcomes. Persistent challenges include legal exposure, training, and cultural adjustments. The full report offers additional information on how leaders are addressing these challenges.