The Role of Nurse Practitioners in Reinventing Primary Care

Nurse practitioners are the principal group of advanced practice nurses delivering primary care in the United States.

The authors of this study reviewed the current and projected nurse practitioner workforce and summarized the available evidence of their contributions to improving primary care and reducing more costly health resource use.

Key Findings:

  • Approximately 70–80 percent of patients who see NPs are more satisfied, have longer consultations, and have more tests, with no appreciable differences in patient outcomes, processes of care, or resource use.
  • Nurse practitioners provided care that was equivalent to that provided by physicians—some studies even indicate care was more effective among selected measures than that provided by physicians.
  • Better results were identified among NPs on measures of patient follow-up; consultation time; satisfaction; and the providing of screening, assessment, and counseling.
  • In a cost analysis conducted by RAND Corporation, the average cost of a nurse practitioner or physician assistant visit was 20-35 percent lower than the average cost of a physician visit. This change in patient care could result in a savings of $4.2-$8.4 billion between 2010 and 2020.

The authors recommend that nurse practice acts—the state laws governing how nurses may practice—be standardized; that equivalent reimbursement be paid for comparable services regardless of practitioner; and that performance results be publicly reported to maximize the high-quality care that nurse practitioners provide.

Funding of this research was provided by NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing.