Shifting Health Care Needs Drive Demand for Nurse Practitioners

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Aging population, passage of ACA create growing need for primary care services

The state of health care is shifting as market trends and patient demands drive the need for expanded primary care services in communities across the country. Primary care needs have already created a strain on capacity in many health care markets with projections sited in the Annual Review of Medicine’s report, “Physician Workforce Projections in an Era of Health Care Reform,” estimating the U.S. will face a shortage of more than 45,000 primary care physicians by 2020.

Doctor listening to heartbeat

In its current state, health care markets will be unable to keep pace with the growing demand for primary care driven most notably by an aging population and the passage of the Affordable Care Act (ACA), which will usher in more than 30 million new insured consumers to the market within the next year. Many states are now considering revising their current laws governing nurse practitioners’ scope of practice in an effort to alleviate demand and expand primary care capacity. In this new proposed role, nurse practitioners would serve at the helm of primary care delivery, providing patient care and treatment services at a basic level.

Current registered nurses can begin transforming their career through continued education to discover a more hands-on role in patient care. King University offers a fully online RN to BSN degree program for nursing professionals taking the first step towards a career as a nurse practitioner. BSN-prepared nurses can enroll in King University’s Master’s of Science in Nursing (MSN) degree program offered on campus for a specialized role in advanced nursing practice.

“King University provides current nurses with a clear path towards career advancement,” said Micah Crews, Associate Vice President of Enrollment Management for Graduate & Professional Studies and Online Programs. “Our online BSN program builds upon a realized foundation created through education and health care experience. The MSN helps develop new leaders for nurses looking to play a stronger role in primary care medicine.”

What is primary care?

Primary care is the foundation of today’s medicine and is often a patient’s entry point into the health care system, providing basic health care for patients including initial health evaluation, ongoing care and preventative services. Medical professionals refer to primary care as relational care because of its innate focus on people and its influence on community health outcomes. Primary care has been defined using the five C’s, including:

  • First contact – Primary care physicians and other medical professionals serve on the front lines of patient care and are often a patient’s first contact within the health care cycle. Primary care can be preventative or the initial contact for diagnosis and treatment of a more serious illness or condition.
  • Comprehensive – Primary care often covers most of a patient’s needs, eliminating the need for costly treatment in hospitals and other emergency care facilities.
  • Continuous – Patients will form ongoing relationships with their primary care provider. These relationships support long-term patient care and treatment.
  • Coordinated – Physicians and medical professionals in the primary care arena of the health care system help to coordinate patient care. They make sure specialists are talking to one another and that the patient is informed throughout their treatment.
  • Context of family and community – Primary care medical professionals get to know the whole family and serve entire communities helping to encourage healthy lifestyles.

Primary care medical professionals have increasingly begun to treat the whole person, including mental, behavioral and physical aspects of health.  Many primary care medical circles now take the team approach to care. These circles can include the following medical professionals:

  • Community health workers
  • Medical assistants
  • Nurses
  • Nurse practitioners
  • Pharmacists
  • Social workers
  • Health educators
  • Respiratory therapists
  • Physical therapists
  • Psychologists
  • Behaviorists
  • Sub-specialists
  • Administrators

Where does the nurse practitioner fit in primary care?Nurse Taking Patients Bloodpressure

Influenced by advancing patient demands, new medical innovations and even government legislation, the health care industry is shifting from treatment-focused patient services to preventive care in an effort to keep patients healthy longer.  And, primary care is an important function of this new patient focus.

Nurse practitioners are central to the function of primary care, delivering patient care and treatment services under the supervision of a physician. However, market trends are putting a strain on an already stretched capacity in many primary care settings, creating a need to revise the role of nurse practitioners in the delivery of patient care services. The National Governors Association’s (NGA) recent report, “The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care,” recommends the expansion of scope-of-practice state laws to allow for more autonomy by nurse practitioners in the delivery of primary care.

Currently, nurse practitioner scope-of-practice laws vary widely by state. According to the “2012 Pearson Report: A National Overview of Nurse Practitioner Legislation and Health Care Issues,” 18 states along with the District of Columbia give nurse practitioners the ability to practice independently of a physician and to the full extent of their training, including diagnosis, treatment, patient referrals and the prescription of medication. Furthermore, seven states require physician oversight for medication prescription while 25 states require physician oversight for the full scope of services, including diagnosis, treatment and prescription of medication. Because of the increasing pressure in the primary care arena of health care, many states have put scope-of-practice legislation up for debate in an effort to expand the role of the nurse practitioner in the primary care setting and free up physicians for more complex medicine.

Private and public payer policies also affect the role a nurse practitioner can play in primary care and are often associated with a state’s scope-of-practice laws. These payer policies often determine the services nurse practitioners can be paid for as well as their payment rate. They also determine whether nurse practitioners are designated as primary care providers and given their own patient panels, and whether these medical professionals can be paid directly. When strict payer policies are in place in addition to restrictive scope-of-practice laws, nurse practitioners are limited to working as employees of a primary care facility such as a physician’s office rather than operating their own practice.

Increasing the supply of nurse practitioners for primary care

The American Academy of Nurse Practitioners reports that 89 percent of nurse practitioners are trained in primary care and more than 75 percent practice in primary care settings. That number is expected to almost double by 2025 according to David Auerbach in his report, “Will the NP Workforce Grow in the Future?” as nurses look to expand their careers through more hands-on patient care and leadership roles. However, the nurse practitioner’s care capacity is still restricted by state regulations and payer policies, which limit the value of nurse practitioners in meeting and alleviating the demand for primary care. To address issues of professionalism and autonomy among state legislatures and payer policy makers, the American Association of Colleges of Nursing (AACN) plans to raise the accreditation standards for advanced nursing practice programs from a master’s degree to a doctoral degree in nursing practice starting in 2015.

Nurses seeking out advanced nursing opportunities must do so through continued education and professional development. From enrollment in an RN to BSN program to completing an MSN, King University offers nursing professionals the platform to take their career to the next level and serve growing patient needs.


Interested in learning more about our Online Nursing Programs? Click here to find out how to obtain your RN to BSN Online!


King University has a reputation for academic excellence that goes beyond the classroom. Our online degree programs position graduates for an exceptional career or continued educational opportunities. More than 80 percent of King graduate survey respondents indicated they received admission to their first choice of graduate programs. Make an investment in your future with an online degree from King University.