Nurse practitioners are the principal group of advanced-practice nurses delivering primary care in the United States.
The employment of more nurse practitioners (NPs) is one of the most promising ways to expand the capacity of medical group practices to meet the projected needs for primary healthcare created by an aging population and increased health insurance coverage under the Affordable Care Act.

New education requirements for health care providers and the increasing clinical complexity of the patient population – has been rearranging the health care system in the US. This evolution has placed an increasing focus on the value of nurse practitioners (NPs) and other advanced practice providers, such as physician assistants, certified registered nurse anesthetists and midwives.

The primary focus for expanding the use of nurse practitioners is efficiency, in both cost and workflow. In the primary care setting Nurse Practitioners, who cost far less to train than do physicians, are educated and credentialed to meet most preventive and chronic care needs of a primary care patient population. A study in Tennessee found that costs at NP-managed practices were 23 percent below the costs of care delivered by other primary care providers. Since NPs’ training and scope of practice include care such as writing orders and prescribing medication, NPs can increase efficiency in the acute care setting by bridging gaps between more and less complex care, between nursing and medical staff, across different hospital services.

Another important role for NPs is facilitating care that crosses the divide between in- and outpatient care. Some services at the medical centers, such as general surgery, are looking at implementing models in which NPs follow patients through the continued care, from outpatient clinic to inpatient stay and through discharge.