Implications of Rising Numbers of Nurse Practitioners

A new blog in Health Affairs analyzes recent data from the American Association of Colleges of Nursing and the National Council of State Boards of Nursing (NCSBN) on the pipeline of new nurse practitioners (NPs) and registered nurses (RNs). It presents the implications for the health care system, nursing and physician education, and federal and state policies.

The blog’s author, Edward Salsberg, directs Health Workforce Studies at the George Washington University Health Workforce Institute and is a member of the research faculty at the GW School of Nursing. His analysis points out that for the first time in 2017, the inflow of NPs and physician assistants (PAs) exceeded the inflow of physicians. At the current rate of growth, the inflow of new NPs alone will exceed the inflow of physicians within two or three years, he predicts.

“The increasing supply of NPs (along with new PAs) is good news for the health care system,” Salsberg writes in the blog. “It gives providers and organizations an opportunity to meet growing health care needs in a cost-effective manner” and should help fill geographic and specialty gaps, he says. He also points out that “the availability of a robust supply of NPs combined with pressures to constrain the growth in costs and to improve efficiency is likely to mean that more health care organizations and physician groups will look to NPs to help meet growing needs.”

Salsberg’s analysis, Changes in the Pipeline of New NPs and RNs: Implications For Health Care Delivery And Educational Capacity, also notes that the sharp growth in NPs has significant implications for the physician and registered nurse (RN) pipeline.  In regard to physicians, the growth in NPs is likely to reduce the likelihood of physician shortages and the need to expand the physician pipeline. On the other hand, since all new NPs come from the pool of RNs, the rapid growth in new NPs may increase the likelihood of an RN shortage and mean we need to increase the RN pipeline.

Finally, Salsberg points out that in 2017, for the first time, the inflow of new nurses entering the profession with a bachelor of science in nursing (BSN) exceeded the number entering with an associate’s degree (ASN).