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How primary care is changing in America

A nurse practitioner during a checkup
A nurse practitioner during a checkup. Photo: Joe Raedle/Getty Images

Nurses and nurse practitioners are gaining a bigger foothold as primary-care providers, while doctors’ roles are slipping.

Details: Among people with employer-based insurance, the number of office visits to primary care physicians fell by 18% from 2012 to 2016, according to new data from the Health Care Cost Institute. Over the same period, office visits to nurses and nurse practitioners rose by 129%.

Between the lines: Nurse practitioners have been lobbying aggressively for state laws that would allow them to practice “at the top of their license” — which would allow them to perform many of the services patients seek from their regular family doctor.

  • That’s been framed largely as a cost-saving measure, under the assumption that nurses would be paid less than doctors for the same service.

Yes, but: Those savings haven’t materialized yet, even amid a pretty significant shift from doctors to other providers.

  • According to HCCI’s data, the average office visit to a primary-care doctor cost $106 in 2016, compared to $103 for an office visit to a nurse practitioner or physician’s assistant.
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