Contents

The Advanced Practice Job Market


Key Trends Shaping the Future
The advanced practice provider job market is undergoing significant transformations, fueled by a perfect storm of factors. The rising physician shortage, an aging population, expanded scope of practice, and evolving healthcare delivery models are all contributing to an unprecedented demand for APPs.

The number of APPs in the United States has surged, growing by more than 50% over the last decade. The U.S. faces a projected physician shortfall of between 37,800 and 124,000 physicians by 2034, with the greatest shortages expected in primary care and surgical specialties. 

As of 2023, there are now over 385,000 NPs, 159,000 PAs, 89,000 CNSs, 54,000 CRNAs, and 13,000 CNMs practicing across the country. In 2020 there were 290,000 NPs. In just 3 years that number has risen by 95,000 providers.

The projected growth rate in the U.S. from 2021 to 2031 is: NPs-45%, adding 112,700 jobs during that period; PAs-27%, adding 38,400 new jobs; CRNAs-12%, adding 5,600 jobs; CNMs-7%, adding 400 jobs. CNSs are expected to experience stable demand.

Specialty Demand

  • Primary Care and Family Practice (NPs and PAs): These are high demand specialties, especially in rural and underserved areas. More than 80 million Americans currently live in areas with primary care shortages.
  • Geriatrics (NPs, PAs, CNSs): The growing elderly population is creating a demand for APPs specializing in geriatric care. By 2040, the number of adults aged 65 and older is expected to nearly double to 80 million.
  • Mental Health (NPs and CNSs): With rising awareness and demand for mental health services, psychiatric-mental health NPs (PMHNPs) and CNSs are in increasing demand. 
  • Surgical Specialties (CRNAs and PAs): Surgical settings are highly sought after, particularly due to the rise in outpatient surgeries. The increase in ambulatory surgery centers is driving demand.
  • Preventative Care and Chronic Disease Management: The shift toward population health management will drive demand for NPs, PAs, and CNSs in outpatient clinics, geriatric care, and specialty practices .
  • Specialty Certification Growth: High-demand areas like acute care, psychiatric-mental health, and geriatrics are expected to command higher salaries and more job opportunities. 
APP Compensation

The compensation growth rates for 2017 to 2023 were: NPs 17%; PA’s 14%; CRNA’s 30% and all the APP average at 25%. 

  • Nurse Practitioners: Salaries can vary widely by specialty. For example, psychiatric NPs and acute care NPs often earn higher-than-average salaries, with some making over $135,000 annually.
  • Physician Associates: Specialized fields such as surgery and emergency medicine tend to earn higher wages, with those in top-paying states making well over $140,000.
  • Certified Registered Nurse Anesthetists: With the highest average salaries among APPs, in some regions and specialized fields, CRNAs earn well over $250,000.
  • Certified Nurse Midwives: In larger metropolitan areas or those working in independent practices may earn the highest salaries.
  • Clinical Nurse Specialists: Salaries vary based on specialization, with acute care and oncology at the higher end of this spectrum.

 

Median Average Salary by APP

  • Certified Registered Nurse Anesthetist: $212,650
  • Physician Associate: $130,020
  • Certified Nurse Midwife: $129,650
  • Nurse Practitioner: $126,260
  • Certified Nurse Specialist: $97,180

 

Median Average Salary by Specialty

  • CRNA-Cardiac Anesthesia: $225,000 There is high demand and competitive salaries, particularly in trauma and cardiovascular centers that require specialized expertise.
  • CRNA-Pediatric Anesthesia Pediatric Anesthesia: $217,500 An expanding demand for pediatric surgical care, particularly in urban children’s hospitals.
  • CRNA-Obstetric Anesthesia: $210,000 There is high demand and competitive salaries, especially in urban maternity hospitals that cater to increasing patient volumes.
  • CRNA-General Anesthesia: $195,610 Increased surgical volume and the ongoing shift towards outpatient procedures elevate the compensation, particularly as primary anesthesia providers.
  • PA – Neurosurgery: $147,500 Neurosurgery PAs are among the highest-paid, reflecting the specialty’s complexity.
  • PA – Cardiovascular/Cardiothoracic Surgery: $143,880 PAs in cardiovascular surgery tend to earn some of the highest PA salaries.
  • PA – Critical Care: $139,000 Critical care PAs working in ICUs often have the potential for higher earnings.
  • PA – Dermatology: $138,000 Dermatology is a high-demand specialty for PAs.
  • PA – Occupational Medicine: $138,000 Salaries are typically stable across various employment sectors.
  • PA – Urgent Care: $137,700 Urgent care centers provide steady demand for PAs, especially in urban areas.
  • PA – Orthopedic Surgery: $136,000 PAs in this specialty often work in surgical settings and see higher wages.
  • PA – Plastic Surgery: $134,688 PAs in cosmetic and reconstructive surgery can earn significantly more depending on the clinic.
  • PA – Hospital Medicine: $133,889 Salaries for hospitalist PAs can vary based on the region and hospital size.
  • PA – General Surgery: $133,060 General Surgery PAs are typically in high demand, especially in large healthcare systems
  • PA – Pulmonology: $132,500 Pulmonology PAs are in demand due to respiratory health needs.
  • PA – Emergency Medicine: $128,870 PAs in emergency settings often receive additional compensation for overtime.
  • CNM-Labor and Delivery Nurse Midwife: $125,000 Growing preferences for midwifery-led births creating demand, particularly in hospitals focusing on family-centered care.
  • CNM-Women’s Health Nurse Midwife: $117,500 A rising awareness of women’s health issues and preventive care is increasing demand, especially in outpatient clinics and community health centers.
  • CNM-Home Birth Midwife: $110,000 There is an increasing number of families seeking personalized birth experiences, particularly in areas with a supportive community for home births.
  • NP – Psychiatric Mental Health: $137,000 This specialty has seen increasing demand, leading to salary growth.
  • NP – Neonatal: $130,200 In high-demand areas, they can earn more, especially in hospital settings.
  • NP – Oncology: $125,300 Demand is high in both outpatient and hospital oncology centers.
  • NP – Emergency: $123,500 Salaries can increase with certifications and experience.
  • NP – Acute Care: $120,680 Acute care positions in hospitals tend to pay higher due to the demand.
  • NP – Adult Gerontology: $120,000 Geriatric care is a growing field, with opportunities for salary increases.
  • NP – Orthopedic: $119,000 Orthopedic NPs working in surgery centers often report higher earnings.
  • NP – Family Practice: $118,040 NPs working in rural settings or underserved areas can sometimes earn more.
  • NP – Women’s Health: $115,000 Higher salaries can be found in specialty women’s health clinics.
  • NP – Pediatric: $112,230 Salaries can vary greatly depending on the practice setting.
  • CNS-Pediatric: $122,500 Growing demand on pediatric care quality and safety, drives demand.
  • CNS-Gerontology: $122,500 Demand for care focusing on complex health issues, particularly in long-term care facilities and home health services.
  • CNS-Cardiac: $117,500 Demand for cardiovascular care, focusing on improving patient outcomes, educating staff on cardiac care and skills in advanced technologies
Geographic Disparities

The distribution of APPs across the United States is uneven, with rural and underserved areas experiencing the most significant shortages. In 2023, the median salary for Nurse Practitioners (NPs) in urban areas was approximately $120,000 to $130,000 annually. In contrast, NPs working in rural or underserved areas tended to earn slightly less, with median salaries typically ranging from $100,000 to $115,000 per year. Despite the lower base salaries, the incentives provided in these areas, combined with the generally lower cost of living, can make them financially attractive to APPs.

There are substantial variations of compensation depending on state, and areas within each state. The cost-of-living component affects compensation as we well as other demand factors. As an example, in 2023 the highest NP salary by state was California at $161,540. North Dakota was 22nd at $127,990. However, when factoring in the cost of living, North Dakota was 4th at $144,036 whereas California was 5th at $143,591. 

 2023 Top NP Salaries by Location

  1.   CA       $161,540
  2.   NV      $148,670
  3.   WA     $145,400
  4.   NJ       $145,030
  5.   OR      $144,950
  6.   MA     $144,010
  7.   NY      $142,830
  8.   CT       $136,980
  9.   NM     $136,770
  10.   MO    $135,010

Adjusted for Cost of Living

  1.  NV       $154,222
  2.  NM     $150,297
  3.  IA        $147,986
  4.  ND     $144,036
  5.  CA      $143,591
  6.  OK     $140,011
  7.  WI      $139,036
  8.  MO    $138,188
  9.  MT     $138,029
  10.  SD     $137,477

Regional Salary Variations

   Nurse Anesthetists

  • Northeast: $200,000 – $230,000
  • Midwest: $190,000 – $210,000
  • South: $180,000 – $200,000
  • West: $210,000 – $230,000

   Certified Nurse Midwives

  • Northeast: $120,000 – $140,000
  • Midwest: $110,000 – $120,000
  • South: $100,000 – $110,000
  • West: $130,000 – $145,000

   Physician Assistants

  • Northeast: $120,000 – $140,000
  • Midwest: $110,000 – $125,000
  • South: $100,000 – $110,000
  • West: $130,000 – $145,000

   Nurse Practitioners

  • Northeast: $120,000 – $135,000
  • Midwest: $105,000 – $115,000
  • South: $100,000 – $110,000
  • West: $130,000 – $145,000

   Clinical Nurse Specialists

  • Northeast: $90,000 – $110,000
  • Midwest: $80,000 – $100,000
  • South: $75,000 – $90,000
  • West: $90,000 – $110,000

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