Practice Management News

Nurse Practitioner Workforce Hits Record High of 290K

The nurse practitioner workforce and their compensation continue to grow as organizations increasingly rely on team-based care.

Nurse practitioner workforce

Source: Getty Images

By Jacqueline LaPointe

- The nurse practitioner (NP) workforce hit a record high of more than 290,000 licensed NPs, according to a new estimate from the American Association of Nurse Practitioners (AANP).

The estimate was published in the latest National NP Sample Survey from AANP. According to AANP, the survey has been conducted periodically since 2007 to capture information regarding compensation and benefits for NPs. This year, the survey contained insights from a total of 5,770 NPs.

NPs are advanced practice registered nurses who have additional patient care responsibilities compared to registered nurses, including diagnosing and treating acute illnesses and prescribing medications. The position has been increasingly used in healthcare organizations across the country, with nearly half of states giving NPs full practice authority.

The latest survey conducted by AANP confirmed that healthcare organizations have become increasingly interested in hiring NPs. This year’s survey revealed that the nurse practitioner workforce continues to grow, increasing from an estimated 270,000 licensed NPs in January 2019.

“Millions of patients — of all ages — choose an NP as their health care provider each year. As the number of seniors increases and the demand for health care access grows, NPs are meeting that need in rural and urban areas across the nation,” Sophia Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president of AANP, stated in the survey’s announcement. “An estimated 1.06 billion patient visits were made to NPs in 2018, improving the health of our nation and increasing the growing number of patients who say, ‘We Choose NPs.’”

And as the workforce increased, so did compensation rates for the advanced practice providers.

NP compensation varied widely based on certification type, additional administrative duties, years of experience, education level, and other factors. However, this year’s survey showed that the median base salary for a full-time MP was $110,00 and the median total income, which included bonuses, was $115,000.

Full-time NPs who were certified in psychiatric mental health had the highest median base salary ($125,000), while emergency NPs earned the most on an hourly basis ($70), the survey report highlighted.

Meanwhile, NPs with an administrative role on top on their clinical position reported a higher median base salary of $120,000. In contrast, NPs who only practiced in a clinical capacity made a median base salary of $108,000.

The administrative roles undertaken by NPs included professional-level positions (e.g., director, manager, or supervisor). About one in seven held an executive-level position, such as CEO, CNO, or owner, AANP added.

The role of the advanced practice provider

The role of the NP and other advanced practice providers like physician assistants continue to evolve as healthcare organizations dive deeper into value- and team-based care.

A recent report from consulting firm SullivanCotter shows that compensation programs for the providers have become more sophisticated to reflect the roles NPs and PAs are playing. Advanced practice provider compensation is now accounting for differences between major specialty categories – primary care, medical, surgical, and hospital-based – as well as the impact the providers have on care.

Nearly half (48 percent) of healthcare organizations report using incentive pay for at least some of their advanced practice providers (APPs), and the median annual incentive amount has increased cross all specialty categories between 2018 and 2019.

“Although there are still some important differences in the design of physician and APP compensation programs, aligning rewards more closely to ensure complementary versus competitive team-based care delivery is important,” said Trish Anen, principal and APP workforce practice leader at SullivanCotter.

“As organizations look to establish and reinforce a clinical team-based mindset, many are considering a strategic restructuring of their APP compensation plans to reflect certain elements of physician pay programs,” she continued.

Yet, physician organizations like the American Medical Association (AMA) continue to caution the industry about the use of such providers. It is the official position of the AMA to oppose full practice authority for NPs and other non-physician professionals.

Regardless, the NP and PA workforces are increasing steadily, especially as physician shortages plague the industry amidst a key transition to value-based care. With the advanced practice providers in high demand, healthcare organizations need to pay attention to compensation trends to stay competitive and ensure a robust workforce.