Number of Nurse Practitioners Has Doubled

The number of nurse practitioners more than doubled between 2010 and 2017, far outpacing the growth in the number of registered nurses and physicians, according to research results reported in the February issue of Health Affairs.

The surge in nurse practitioners is already reflected in the growing share of Medicare evaluation and management office visits billed by nurse practitioners. The researchers noted as more registered nurses continue their education so they can become nurse practitioners, the “RN-to-NP” conversion could lead to staffing problems at hospitals, although probably not serious or long-term nursing shortages.

They also discuss the possibility of a glut of nurse practitioners in the years to come and access to online learning as a contributing factor to the swelling of nurse practitioner ranks.

The number of FTE nurse practitioners increased from 91,000 in 2010 to 190,000 in 2017, an increase of 109%, according to the trio of researchers, David Auerbach and Peter Buerhaus of the College of Nursing at Montana State University and Doulgas Staiger at Dartmouth.

During that same period, the number of registered nurses increased from about 2.5 million to 3 million, a 22% increase, while the total number of physicians grew from 870,000 to 950,000, an increase of 9%.

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The absolute number of registered nurses puts the relative increase in the number of nurse practitioners in some perspective. As large as that increase is, the ratio of registered nurses to nurse practitioners is still roughly 16 to 1.

Auerbach and his colleagues cited MedPAC figures showing the share of Medicare evaluation and management office visits billed by nurse practitioners (and physician assistants) grew from 4.6% in in 2010 to 12.3% in 2017 and the share of Medicare beneficiaries who received at least one service for which a nurse practitioner or physician assistant billed more than doubled (16% vs. 34%) over that period.

They used occupation data from Census Bureau’s American Community Survey to conduct their research. Occupation is self-described in that data, they noted, and that could explain why their estimate of the number of nurse practitioners is less than the American Association of Nurse Practitioners figure of 240,000 licensed nurse practitioners in 2017.

Nurse practitioner education has changed dramatically, according to Auerbach and his coauthors. In the past, registered nurses had to attend in-person lectures and get hands-on clinical training to become nurse practitioners. Data from the American Association of Colleges of Nursing show that 175 of 376 nurse practitioner programs are offered mainly online and 52 are completely online.