In 2020, more nurse practitioners than physicians entered the provider workforce. Now, as workforce shortages persist and healthcare organizations struggle to meet patient demand for care, industry experts say having a strategic mix of advanced practice providers is critical.
The healthcare consulting firm Kaufman Hall published its annual state of healthcare performance report Oct. 24, which was based on a survey of 106 hospital and health system leaders across the U.S. It found that 63% of respondents said their organizations are struggling to meet demand for patient access to physicians. Meanwhile, nearly half of the leaders reported increasing volumes for care in outpatient settings.
"A lot of that is still due to pent-up demand from the pandemic, particularly around elective cases like colonoscopies, for instance; a lot of people put those off," Lance Robinson, managing director and practice leader of performance improvement at Kaufman Hall, told Becker's. "Now they're coming back into the care delivery models and it's increasing volumes," placing additional pressure on physicians.
By now, it is clear many workforce shortages are here to stay, and experts say organizations should think differently about their care delivery models if they want to do a better job of keeping up with care demands and controlling costs.
"Our recommendation is that clients look at how they are employing APPs as a mix with the physicians because there's a lot more of them out in the market right now than there are physicians," Mr. Robinson said.
About 36,000 nurse practitioners entered the healthcare workforce in 2020, alongside nearly 10,000 physician assistants and 2,600 certified registered nurse anesthesiologists. Together, they made up more than 60% of providers entering the workforce. Only 37% were physicians, according to a Kaufman Hall analysis of data from professional societies. Increasingly, this shift is manifesting in primary care and hospital settings.
Through interviews and analyses of performance data, the firm has found organizations that leverage a higher percent of APPs in their respective workforces increasingly outperform peers on productivity and compensation metrics.
"One high-performing academic health system in the Southeast now employs four APPs for every physician in their hospitalist and internist services," the firm previously said in a blog post. "With labor costs that are about a third as much per APP (versus per physician), the system is able to staff its intensive care units with APPs while physicians oversee clinical delivery from a centralized, systemwide e-command center."
Recently, Keck Hospital of USC in Los Angeles started hiring more nurse practitioners, which has supported efficiency in the nursing department, the hospital's chief nursing officer, Ceonne Houston-Raasikh, DNP, RN, told Becker's.
In addition to supporting the work of physicians, nurse practitioners "are working very closely with the nurses," she said. "Sometimes if a nurse doesn't want to reach out to the medical staff, they can reach out to the NP who is there in the unit and can get orders more quickly if they need them. Adding them to our care delivery model has been very successful for the work that we do."