The Workers’ Compensation Research Institute (WCRI) published a new study that examines shifts in the medical workforce and their impact on injured workers, focusing on provider shortages, rising healthcare demand, and reliance on advanced practitioners (nurse practitioners and physician assistants) from 2013-2022.
While the report noted pandemic-related increases in provider vacancies, it appears those vacancies had minimal impact on claim costs, duration of disability, or types of care. Instead, there was a shift from providers to advanced practitioners.
First office visits with physicians dropped from 81% in 2013 to 60% in 2022, while the percentage of visits with nurse practitioners rose from 11% to 22% in the same timeframe, while visits to physician assistants rose from 5% to 16%.
In 2022, advanced practitioner use exceeded 50% in states like Indiana, Nevada, New Mexico, and North Carolina, but remained below 25% in Delaware, Kentucky, New Jersey, and Virginia.
In rural areas, nurse practitioners handled 26% of first visits in rural areas by 2022.
The participation of nurse practitioners and physician assistants in direct patient care has been increasing substantially since 2010. The average county-level number of nurse practitioners per capita nearly tripled from 2010-2023. The average county-level number of physician assistants per capita increased roughly 50% from 2010 to 2022.
These providers can practice either under the supervision of a physician or independently to provide primary care, depending on state regulations and/or practice agreements. WCRI noted that this opens opportunities for organizations to expand the number of providers available to treat patients, even when the number of physicians is limited.
The report did note a small increase in the duration of temporary disability due to increases in the number of nurse practitioners per population, as being cleared to return to work may require seeing a physician.
The study utilized data from multiple sources. External data helped determine the number of providers in the market, while workers’ comp billing and claims data helped identify providers treating workers after their injuries, the use of different types of care, and important claim measures, such as time to first service, claim costs, and duration of temporary disability.
