Improving Access to Adult Primary Care in Medicaid: Exploring the Potential Role of Nurse Practitioners and Physician Assistants

The inadequate supply of primary care providers is among the major challenges facing the U.S. health care system. Sixty-five million people live in areas designated by the federal government as having a shortage of primary care providers. Under the Patient Protection and Affordable Care Act (ACA), the pressures on access are certain to grow as millions of newly insured people enter the health care system. By 2020, the U.S. will face an estimated shortage of 91,000 physicians, split about evenly between primary care physicians and specialists. The impact of this shortage is likely to be more acute among Medicaid beneficiaries due to geographic misalignment between low-income communities and physician practice locations and low physician participation in Medicaid.

Anticipating increased demands for primary care as more people gain coverage, ACA put in place strategies to help build primary care capacity. One of them is greater reliance on primary care health professionals other than physicians. This brief provides basic information about two major types of primary care providers – nurse practitioners and physician assistants – and considers their potential to increase the supply of primary care as Medicaid expands to cover more uninsured adults.

Issue Brief (.pdf)