One of the biggest, but often overlooked drivers in the use of non-physician providers, Singleton says, is that payers are now recognizing and reimbursing for the services they provide. "That is the difference. It is going to follow the money," he says. "If the third-party payers continue the trend of recognizing more and more expanded duties by NPs and PAs you are going to see people use more of them."
Tight Demand, 'Spotty Supply'
With demand for non-physician providers expected to remain strong, Singleton says the supply will remain tight and "spotty" in different parts of the country and within urban and rural settings. "Unlike the MD population, we are able to affect NPs and PAs much more quickly," he says. "Even though you are only seeing an increase in schools of 2% to 5%, we have seen a really healthy increase over the last decade."
Unfortunately for proponents of primary care, a growing number of non-physician providers are following physicians into more urban areas and into subspecialties because that's where the money is. "It's a much easier quality of life and it pays a lot better," Singleton says. "Where we need them most is in general primary care."
"For NPs specifically, 88% are focusing on primary care. But only 18% of those are in rural areas, and rural areas are where we need them the most."