How Could Nurse Practitioners and Physician Assistants Be Deployed to Provide Rural Primary Care?


Eric H. Larson, PhD, C. Holly A. Andrilla, MS, Cynthia Coulthard, MPH, Joanne Spetz, PhD

March 15, 2016

The Affordable Care Act is projected to result in nearly three-quarters of a million additional insured people in rural regions of the U.S. These newly insured are expected to generate 1.39 million rural primary care office visits. At a national level it would require 345 full-time equivalent physicians to provide those visits to new rural enrollees. If only 70 percent of those visits were provided by physicians, 56 additional full-time physician assistants (PA) and 68 additional full-time nurse practitioners (NP) would be required to provide the remainder. Using PAs and NPs to help meet the needs of newly insured populations in rural areas may be an effective strategy to alleviate the effects of physician shortage, especially in states with less restrictive practice environments for non-physician primary care providers.