Advance Practice Clinicians Proliferating in Specialty Practices Save

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

APCs were more likely to be employed by multispecialty practices (49%) and less so by surgical specialties (21%). 

Specialties employing >25% APCs included cardiology, obstetrics-gynecology, dermatology, gastroenterology, and orthopedic surgery.

Most specialties employed more NPs than PAs, with the exception of some surgical practices  (e.g., orthopedics) and dermatology which relied more on PAs.

(Although collected, data APC employment in rheumatology was not published).

The authors speculate that some of this APC growth may be driven by recent increases in graduates from advanced practice clinician programs, the emergence of value-based practice models that are incentivizing team-based care, and pressure to reduce the costs of care delivery, making APC employment more attractive.