New analysis shows increase in visits to NPs and PAs, a drop in primary care visits

A new analysis by the Health Care Cost Institute (HCCI) — using data from Aetna, Humana, Kaiser Permanente and UnitedHealthcare — showed that primary care physicians saw 18 percent fewer patients from 2012 to 2016. However, in the same timeframe, visits to nurse practitioners (NPs) and physician assistants (PAs) increased by 129 percent, which accounted for 42 percent of the total decline in primary care visits.

Other findings from the analysis include:

  • 51 percent of office visits in 2012 were to primary-care physicians, a number that fell to 43 percent in 2016
  • Authors of the study indicate that the demand for physicians is expected to continue to outpace the number of new doctors joining the workforce.  This, combined with a patients preference to see a specialist directly without visiting a primary care physician for a referral, could be contributors to this decline
  • The average cost of an office visit to a primary care physician ($106 in 2016) is similar to that of a visit to a NP or PA ($103 in 2016)

The Association of American Medical College (AAMC) estimated in a report released earlier this year that there will be a shortage of 14,800 to 49,300 primary care doctors by 2030, an increase from its previous year estimates. A co-author of the HCCI study indicated that changes in scope of practice laws have allowed NPs and PAs greater freedom to practice independent of physicians in many states, and could be especially helpful to fill the void of primary care physicians in more rural areas of the country.


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