More on Workforce

While PCP office visits decline, stats for NPs and PAs are way up showing promise for bridging future care gaps

Primary care visits to nurse practitioners and physician assistants increased 129 percent from 2012 to 2016, report shows.

Beth Jones Sanborn, Managing Editor

As a major physician shortage looms, especially in primary care, advanced practitioners are proving valuable in closing gaps and increasing access to care. A report by the the Health Care Cost Institute showed that while office visits to primary care physicians declined 18 percent from 2012 to 2016 for adults under 65 years old with employer-sponsored health insurance, primary care visits to nurse practitioners and physician assistants increased 129 percent. The brief, Trends in Primary Care Visits, also showed a 2 percent drop in all office visits from 2012 to 2016.


Experts are predicting a shortage of physicians over the next decade by the tens of thousands, with the gap at least partially concentrated in primary care. The staffing of NPs and PAs is emerging as a salient solution to bridging the potential care gaps, increasing access to care by enhancing staff and serving as additional clinicians capable of treating patients. By boosting staff with these advanced clinicians, patients may have to wait less time to get appointments and receive care.


Compared to 2012, there were 273 fewer office visits per 1,000 insured individuals to primary care physicians in 2016. At the same time, nurse practitioners and physician assistant visits increased from 88 visits per 1,000 insured members to 201. The increase in utilization of NPs and PAs did not result in cost savings.

The report showed that the decline in office visits to PCPs was pervasive across the country, with every state seeing the declines between 2012 and 2016 also showing the increases in NP and PA visits. The largest overall decline in PCP office visits was 31 percent in North Dakota and the largest increase in NP/PA visits was 285 percent in Massachusetts.

For this report, HCCI analyzed all claims from 2012 to 2016 for adults under 65 with employer-sponsored health insurance offered by Aetna, Humana, Kaiser Permanente and UnitedHealthcare. Population-weighted samples were used to analyze the trends in utilization. A second sample of the same demographic group was taken from Aetna, Humana, and UnitedHealthcare and used to analyze trends for established patient office visits.


"The decline in primary care visits comes at a time when awareness has grown of the role of primary care in prevention and in containing overall medical spending," said Niall Brennan, president and CEO of HCCI. "We saw these trends in our annual report and wanted to explore them more fully to shed light on this aspect of rising healthcare costs."

Twitter: @BethJSanborn
Email the writer:

Show All Comments