How primary care is changing in America

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.