2020 AANP National Nurse Practitioner Sample Survey Results
1 | Page
©
American Association of Nurse Practitioners, 2021
Dear Colleague,
We are pleased to present you with the results from the 2020 National Nurse Practitioner Sample
Survey. While 2020 was truly an outlier year due to COVID-19’s unprecedented impact on the health
care delivery system and health care professionals, we believe that continuing to report on the current
state of the nurse practitioner profession is critical and encourage you to interpret these results with
caution. Importantly, while the general demographics of NPs do not show significant changes
compared to recent years, key differences were observed in services provided and prescribing. It is
unclear if these changes are due to the rapidly shifting work environments and proliferation of
telehealth services exacerbated by the spread of COVID, or the continued delays in care for patients
needing chronic disease management.
Additionally, as you review the information within, please keep in mind that the survey had a lower
response rate than previous years. Health care professionals received an unusually large number of
requests to complete surveys due to the national public health emergency in 2020, and AANP was not
alone in experiencing declines in survey response rates. To the NPs who graciously took the time to
share their information for these surveys, please accept my sincerest thanks. We could not do this
without you.
AANP continues to serve as a robust resource on NPs and their practices and houses the only
comprehensive database of NPs in the United States. As we navigate the challenges of vaccine roll-out
in the year ahead, we are committed to keeping NPs updated on the latest resources, sharing your
stories and summary data with key stakeholders and policymakers, and highlighting the critical work
you are doing in caring for the nation’s patients.
Sincerely,
Chris
Christine Tracy
Vice President of Research
American Association of Nurse Practitioners®
2020 AANP National Nurse Practitioner Sample Survey Results
2 | Page
©
American Association of Nurse Practitioners, 2021
Table of Contents
Introduction ...................................................................................................................................... 4
Methods ........................................................................................................................................... 4
Limitations ........................................................................................................................................ 4
Section I: General Results .................................................................................................................. 5
Demographics ......................................................................................................................................................................... 5
Education ................................................................................................................................................................................ 5
Certification............................................................................................................................................................................. 5
Practice Community and Setting ............................................................................................................................................ 5
Employment Characteristics ................................................................................................................................................... 6
Compensation .......................................................................................................................................................................... 6
Practice Characteristics .......................................................................................................................................................... 6
Billing Information ................................................................................................................................................................. 7
Section II: NP Services Results ........................................................................................................... 7
NP Patient Characteristics ...................................................................................................................................................... 7
NP Patient Volume .................................................................................................................................................................. 8
NP Services .............................................................................................................................................................................. 8
NP Consultation and Referral ................................................................................................................................................. 8
Section III: NP Prescribing Results ...................................................................................................... 8
NP Prescribing by Certification .............................................................................................................................................. 9
NP Prescribing by Practice Community and Setting .............................................................................................................. 9
NP Prescribing by Drug Agent Type ....................................................................................................................................... 9
Drug Information .................................................................................................................................................................... 9
2020 AANP National Nurse Practitioner Sample Survey Results
3 | Page
©
American Association of Nurse Practitioners, 2021
Section I: General Results Tables & Figures
Table 1.1: Distribution of NPs by Race
Table 1.2: Distribution of NPs by Age Group
Table 1.3: Distribution of NPs by AANP Region
Table 1.4: Distribution of NPs by Census Region
Table 1.5: Distribution of NPs by Military Status
Table 1.6: Distribution of NPs by Initial NP Education Level
Table 1.7: Distribution of NPs by Highest Degree Awarded
Table 1.8: Distribution of NPs by Primary Certification Area
Table 1.9: Distribution of NPs by Advanced Certification Area
Table 1.10: Distribution of NPs by Main Work Site Community Size
Table 1.11: Distribution of NPs by Years of NP Experience
Table 1.12: Distribution of NPs by Main Work Site Setting
Table 1.13: Distribution of NPs by Top NP Clinical Focus Area
Table 1.14: Top NP Work Site Settings by Top NP Clinical Focus Areas
Table 1.15: Median Hourly, Annual Base and Total Salary by Top 10 NP Work Site Settings
Table 1.16: Median Hourly, Annual Base and Total Salary by 10 NP Clinical Focus Areas
Table 1.17: Median Hourly, Annual Base and Total Salary by Primary Certification Area
Section II: NP Services Tables & Figures
Table 2.1: Percent of NPs Who Deliver Health Care by Patient Age Group
Table 2.2: Percent of NPs Who See and Accept Patients by Payment Type
Table 2.3: Percent of NPs With High Influence on the Types of Patients Accepted in Their Practice
Table 2.4: Percent of NPs Treating Patients Below the Poverty Level by Community Size
Table 2.5: Average Number of Patients Seen per Day by NP Work Site Setting
Table 2.6: Average Number of Patients Seen per Day by NP Clinical Focus Area
Table 2.7: Frequency of Patients Provided NP Services
Table 2.8: Percent of NPs Consulting with Other Health Care Providers
Table 2.9: Top Three NP Referrals by Top 10 NP Work Site Settings
Figure 2.1: Percent of NPs by Diagnoses Treated
Figure 2.2 Percent of Primary Care NPs by Provider Type Patients are Referred to
Figure 2.3 Percent of Non-Primary Care NPs by Provider Type Patients are Referred to
Section III: NP Prescribing Tables & Figures
Table 3.1: Mean and Median Prescriptions per Day by Top 10 NP Certification Areas
Table 3.2: Prescribing by Top 20 NP Work Site Settings
Table 3.3: Prescribing by Community Size
Table 3.4: Top 10 Agents Prescribed Regularly (>15 times per week) by NPs
Table 3.5: Sources of Information on New Drugs
Figure 3.1: Mean Prescriptions Written/Refilled per Day by Patient Volume
2020 AANP National Nurse Practitioner Sample Survey Results
4 | Page
©
American Association of Nurse Practitioners, 2021
Introduction
In the fall of 2020, the American Association of Nurse Practitioners® (AANP) completed the tenth iteration of the
National Nurse Practitioner Sample Survey (NNPSS) that focused on key practice elements and issues. Previous
versions were conducted in 1999, 2004, 2009-10, 2012, 2016 and 2018. The purpose of this survey was to
identify the characteristics and practices of nurse practitioners (NPs) nationwide. The survey consisted of 98
questions relating to NP certification; practice communities, settings and characteristics; salary information;
prescribing and diagnosis; NP education; and demographics. This report is broken out into three sections
beginning with a basic overview of the findings, followed by a review of results on services provided by NPs and
finally information related to NP prescribing.
Methods
The sampling frame for this survey was pulled from the AANP National NP Database, which includes contact
information from AANP members and customers as well as from state regulatory agencies. NPs were included if,
in the past year, they were reported by a state licensing agency that did not restrict the use of their contact
information for research and if the NP had a valid email address from the state board or from an existing
business relationship with AANP. The resulting database contained approximately 166,239 records available for
sampling and a random sample of just over 55,000 was generated.
The survey was administered by internet only. Those who had a valid email address available to AANP were sent
a unique link to the online survey in an email invitation with a request to participate. Non-responders were sent
follow-up emails weekly. Additional reminders about the survey were sent through AANP E-bulletin, a weekly
update sent to all AANP members, and AANPNR Digest, a monthly newsletter sent to members in the AANP
Network for Research.
A total of 3,994 respondents completed the survey for a response rate of 7.3 percent, using the American
Association of Public Opinion Research Outcome Rate Calculator, Version 4.0. A multivariate weighting
adjustment was used to adjust for sampling bias and for subtle over- and under-representations of certain
demographic and geographic groups using standards established by the 2013–14 National NP Practice Site
Census. The final weighted data file was projected to be representative of the more than 290,000 licensed NPs
in the U.S.
This report is limited to the NP respondents who were clinically practicing at the time of their participation;
therefore, 296 respondents were not included in the analysis because they were not clinically practicing at the
time. Additionally, unless otherwise noted (e.g., salary and patients seen), data presented throughout this
report is from NPs who reported working or volunteering full- and part-time.
Limitations
The 2020 National NP Sample Survey was designed to provide a national snapshot of NPs and does not
necessarily reflect local or regional environments. Regional or state-based data will be made available on a case-
by-case basis, depending on the stability of point estimates. While several attempts were made to eliminate bias
through questionnaire design, sampling and weighting strategies, self-reported data is always associated with a
certain level of response-bias based on factors such as social desirability and differences in question
interpretation.
Please note, sample survey report materials and data may not be reproduced or retransmitted in any form
without the expressed written consent of AANP.
2020 AANP National Nurse Practitioner Sample Survey Results
5 | Page
©
American Association of Nurse Practitioners, 2021
Section I: General Results
Demographics
Respondents were asked to report their demographic information to characterize the composition of the
workforce. Respondents were able to select more than one race (see Table 1.1); NPs described themselves as
White (79.4%), Black/African American (8.1%), Asian (4.3%), American Indian/Alaska Native (0.5%), Native
Hawaiian/Other Pacific Islander (0.2%) or Multiracial (2.3%). A majority (95.0%) described themselves as not
Hispanic or Latino, while 5.0 percent indicated they were Hispanic/Latino. On average, clinically practicing NPs
were 49 years old, and approximately 90.6 percent were female. Table 1.2 depicts the distribution of age groups
of the clinically practicing NP population.
Respondents were also geographically diverse, with a large concentration of NPs located in the South. Tables 1.3
and 1.4 provide additional details on the proportion of respondents by both AANP and U.S. Census region.
Additionally, when asked about their military background, 7.3 percent of NPs indicated current or previous
active duty military service (see Table 1.5).
Education
When asked about their initial NP education, the vast majority reported that it was a master’s degree (95.1%),
and an estimated 17.9 percent indicated a doctoral degree as their highest level of education (see Tables 1.6
and 1.7). In addition to their NP preparation, 5.6 percent of NPs were educated in an additional Advanced
Practice Registered Nurse role (i.e., Clinical Nurse Specialist or Certified Nurse Midwife).
Certification
Given that some NPs are certified in multiple population areas, respondents were able to select more than one
certification. The NP workforce most frequently reported certifications in the populations of Family (69.7%),
Adult (10.8%) and Adult-Gerontology Primary Care (7.0%). Tables 1.8 and 1.9 depict the distribution of each NP
certification. A total of 88.9 percent of NPs were certified in an area of primary care. Please note, there are
observed differences in the percent of NPs reporting certifications in Psychiatric/Mental Health in 2020,
compared to previous years due to the collapsing of three categories of Psychiatric/Mental Health certifications
(i.e., Psychiatric/Mental Health Across the Lifespan, Psychiatric/Mental Health Family and Psychiatric/Mental
Health Adult) into a single Psychiatric/Mental Health selection.
Practice Community and Setting
NPs worked in communities of all sizes and demonstrated a commitment to their current community and work
site setting. More than 15.0 percent of NPs work in communities with a population of less than 10,000, and 4.2
percent of NPs work in communities with a population of less than 2,500 (see Table 1.10). In these smaller
communities, NPs most frequently practiced in rural health clinics. Nearly one in six NPs practiced in large urban
areas, where they were most likely to work in hospital outpatient clinics. A total of 63.3 percent anticipated
practicing in their current communities for six or more years, and 51.2 percent anticipated practicing in their
current work site for six or more years.
On average, NPs had been in practice for 11 years, but over a third (37.2%) had been in practice five years or
fewer. This group of early career NPs has continued to grow, since the number of new NP graduates has been
steadily increasing. Table 1.11 depicts the distribution of NPs by number of years in practice. Overall, NPs report
a high level of job satisfaction; 78.4 percent were satisfied or very satisfied with their employment at their main
NP work site.
2020 AANP National Nurse Practitioner Sample Survey Results
6 | Page
©
American Association of Nurse Practitioners, 2021
Given that NPs work in various practice environments, we asked them to report, in addition to their population
area of certification and work site setting, the area of patient care that they focus on at their work site. Table
1.12 lists the 10 most common work site settings for NPs and Table 1.13 provides the top ten areas of patient
care focused on by NPs. NPs were most likely to work in hospital outpatient clinics (14.3%), private group
practices (10.4%), hospital inpatient units (10.0%) and private physician practices (7.8%), and they were most
likely to focus on care delivered to families within those settings (see Table 1.14). Prior to 2020, most
respondents indicated a clinical focus of Primary Care within these settings, however, Family was added as a
new clinical focus option in 2020 to bring selections into alignment with clinical focus areas in other national
surveys. Among many other settings, NPs also frequently reported working in urgent care (4.3%) and private NP
practices (3.8%).
Employment Characteristics
At their main NP work site, 74.1 percent had an employment contract and 71.5 percent had their own patient
panel. When asked about the employment arrangement at their work site setting, 68.2 percent of NPs were full-
or part-time staff or faculty and 3.8 percent were practice owners. The percent of staff or faculty differs
significantly from 2019 (92.3%) potentially due to the new addition of a category for contract-based
employment arrangements. Notably, 21.6 percent of NPs reported contract employment arrangements in 2020.
Compensation
When asked about the compensation arrangement at their main work site, 68.4 percent of NPs were salaried,
25.9 percent were hourly and 5.7 percent were self-employed. For the purposes of this study, salary and hourly
rates excluded benefit packages, including health insurance, retirement plans, etc. The median base salary for a
full-time NP (35+ hours per week) was $110,000. The median total annual income (which includes base salary,
productivity bonuses, incentive payments, etc.) for full-time NPs was $117,000. The median hourly rate for all
NPs, regardless of the number of hours worked, was $58.00.
NP compensation varied greatly based on several variables, including work site setting (see Table 1.15), NP
clinical focus and certification area. Table 1.16 provides the median hourly rate, base salary and total annual
income for the top 10 NP clinical focus areas, and Table 1.17 reports the same information by NP certification.
Among NP certifications, Psychiatric/Mental Health had the highest median annual base salary for those working
full time. Salary data were withheld if there were fewer than 10 respondents prior to weighting. Nearly 34
percent (33.6%) of NPs received an incentive payment or bonus, which was most frequently determined by
number of patient encounters (44.9%), quality measures/outcomes (44.1%), practice revenue/profit (35.5%),
Relative Value Units (33.0%) and patient satisfaction (30.6%).
Practice Characteristics
In addition to clinical practice, 15.4 percent of NPs had administrative roles at their main NP work site. A
majority (66.2%) described their administrative role as a “professional-level” position (e.g., director, supervisor
or manager), and about one in seven (14.5%) held an “executive-level” position (e.g., CEO, CNO or owner).
NPs practiced alongside a wide variety of health care providers at their work site setting. About three-quarters
(74.5%) worked with other NPs, 48.3 percent with physician specialists and 45.3 percent with primary care
physicians. NPs also practiced alongside naturopaths, chiropractors, certified nurse midwives, clinical nurse
specialists and audiologists, but less frequently.
More than one in 10 (12.8%) NPs had nursing home/long-term care privileges, while 42.5 percent of NPs had
hospital privileges. Among the NPs with hospital privileges, 74.3 percent said they could write orders without a
2020 AANP National Nurse Practitioner Sample Survey Results
7 | Page
©
American Association of Nurse Practitioners, 2021
physician co-signature. More than one-third (39.5%) of NPs had to write prescriptions with a physician co-
signature, 58.1 percent could discharge patients and 54.1 percent had admitting privileges.
Billing Information
Almost all NPs (99.7%) have a Medicare provider number (National Provider Identifier [NPI] number), and close
to two-thirds (62.8%) were directly credentialed with commercial insurance companies. When asked about their
billing practices, NPs who indicated having an NPI said that, on average, 41.4 percent of their encounters with
Medicare patients were billed directly under their name/NPI number, with 28.5 percent billing for Medicare
encounters directly under their name/NPI number 100 percent of the time. For those directly credentialed with
commercial insurance companies, more than half (58.6%) of encounters with commercially insured patients
were billed directly under their name/NPI number, with 39.8 percent billing directly under their name/NPI
number for their commercially insured patient encounters 100 percent of the time.
Section II: NP Services Results
NP Patient Characteristics
NPs treat patients from all age groups and from all economic backgrounds, and they play a major role in the
provision of care to Medicare and Medicaid beneficiaries. On average, Medicaid beneficiaries made up 25.4
percent of all NP patients, and Medicare beneficiaries (both fee-for-service and managed care) made up 31.2
percent. NPs also play an important role in providing care to underserved communities; on average, NPs
estimated that 3.5 percent of their patients received charitable care.
NPs reported providing high-quality health care to patients of all ages, income levels and insurance types. Table
2.1 depicts the percentage of NPs who deliver health care, broken down by patient age group. Most NPs (90.0%)
reported seeing patients between 41 and 65 years of age. Additionally, 34.4 percent of NPs reported seeing
patients between the ages of zero and five years of age and 100 percent of Neonatal certified NPs reported
seeing patients in this age group.
Table 2.2 depicts the percentage of NPs who see and accept patients at their main work site setting, by payment
type. Most NPs reported seeing patients covered by commercial insurance (83.7%), Medicare (81.0%) and
Medicaid (78.7%). Additionally, most NPs reported accepting new patients covered by commercial insurance
(79.0%), Medicare (74.3%) and Medicaid (71.7%), while only 12.8 percent reported currently accepting patients
covered by concierge/direct primary care at their work site setting. NP practice owners reported being much
more influential on whether their work site accepts patients with different insurance types, while those in
physician-owned or private group practices reported very little influence on the types of patients accepted at
their work site. Table 2.3 depicts the percentage of NPs and level of influence they have on which types of
patients are accepted at their practice.
A majority (92.1%) of NPs reported seeing patients below the poverty level (annual income of $13,300 or less for
an individual, and $26,370 for a family/household of four - 2019 U.S. Census Bureau). Table 2.4 depicts the
percentage of NPs who see patients below the poverty level, broken down by community size. In relation to NP
work site setting, 100 percent of NPs working in rural health clinics reported seeing patients below the poverty
level.
Almost 59.0 percent of NPs reported that they have patients who receive home health services. Additionally,
45.9 percent reported having patients receiving hospice care.
2020 AANP National Nurse Practitioner Sample Survey Results
8 | Page
©
American Association of Nurse Practitioners, 2021
NP Patient Volume
On average, full-time NPs reported seeing three patients per hour and 16 patients per day; however, these
figures varied depending on primary work site setting. NPs in urgent care settings saw 29 patients per day, on
average. NPs with a clinical focus in urgent care or dermatology both reported seeing an average of 26 patients
per day. As it relates to the average number of patients seen per day, Tables 2.5 and 2.6 depict the 10 work site
settings and 10 NP clinical focus areas with the highest average of patients seen per day.
NP Services
NPs reported diagnosing and treating a wide variety of issues in their practices. Figure 2.1 displays the top
diagnoses treated by NPs. The most frequently reported diagnoses treated by NPs were abdominal pain (69.4%),
anxiety (67.2%) and urinary tract infections (UTIs) (66.7%). NPs working in hospital outpatient clinics and
inpatient units reported abdominal pain as the top diagnosis treated (56.9%). Private group practices reported
abdominal pain (78.1%) as the top diagnosis treated whereas private physician practices reported UTIs (70.1%).
Nearly all NPs working in emergency room settings reported treating anxiety (96.5%), migraines (95.5%) and
acute lower respiratory illness (95.4%), most frequently.
NPs reported providing a wide variety of services for their patients. A majority, 85.4 percent, reported providing
education and counseling for most of their patients, while only 24.1 percent reported performing procedures to
most of their patients (see Table 2.7).
NP Consultation and Referral
In addition to providing services for their own patient panels, NPs also report seeking consultation on behalf of
their patients as well as referring patients to other care providers (see Table 2.8). NPs refer patients to specific
types of services and health care providers. Full-time NPs reported referring an average of seven patients to
home health and three patients to hospice care per month.
Figures 2.2 and 2.3 depict the percentage of primary care and non-primary care focus NPs who refer to other
health care providers. NPs working in hospital outpatient clinics and inpatient units, private group practices and
private physician practices referred to physician specialists the most. Table 2.9 depicts the top three health
professionals NPs refer to by the top 10 NP work site settings.
Section III: NP Prescribing Results
NPs are authorized to prescribe in all 50 states and Washington D.C., and almost all (96.2%) NPs indicated that
they prescribe pharmacologic agents for patients. All data reported in this section are for NPs working full time
who reported data on the number of patients seen per day and the number of prescriptions written per day.
Overall, NPs wrote an average of 21 prescriptions/refills and saw an average of 16 patients per day. More
importantly, the reported average number of prescriptions/refills per day varies significantly based on the
reported average number of patients seen per day. Figure 3.1 depicts the relationship between daily patient
volume and number of prescriptions. The results show that as the average number of patients seen per day
increases, so does the average number of prescriptions an NP writes. NPs who saw fewer than five patients per
day wrote an average of five prescriptions per day, while those who saw more than 30 patients wrote an
average of 32 prescriptions per day. These data should be interpreted with caution. While the data may suggest
that NPs write slightly more than one prescription per patient per day, this interpretation is incorrect, because
the number of prescriptions written per day by NPs may also include refills and pharmacists’ requests for
patients not included in the count of patients seen in person.
2020 AANP National Nurse Practitioner Sample Survey Results
9 | Page
©
American Association of Nurse Practitioners, 2021
NP Prescribing by Certification
Table 3.1 displays the percentage of NPs from the top 10 population certification areas that prescribe as well as
the mean and median number of prescriptions/refills written per day by NPs working full time in clinical
practice. NPs certified in Psychiatric/Mental Health reported writing the highest average number of
prescriptions per day at 27.
NP Prescribing by Practice Community and Setting
Table 3.2 shows the percentage of NPs who prescribe, and the average number of prescriptions written per day
by the top 20 work site settings for full-time NPs. NPs working in VA facilities, federal qualified health centers,
private NP practices and community health centers wrote the most prescriptions/refills on average, with 32, 32,
29 and 29 per day, respectively. NPs who work in college student health wrote the smallest average number of
prescriptions per day, at eight.
Table 3.3 contains similar data organized by community size. Nearly all NPs prescribe medications in every
community size; however, the average number of prescriptions written varied depending on the size of the
community. NPs who served communities of more than 50,000 wrote an average of 18 prescriptions per day.
NP Prescribing by Drug Agent Type
Table 3.4 show the top 10 pharmaceutical agents prescribed by NPs regularly (>15/week). Drugs that NPs
prescribed the most in the “regular” category included antihypertensives, dyslipidemic agents and diabetic
agents. The top drugs that were “never” prescribed were antineoplastic agents, autonomic drugs and disease
modifying agents.
Drug Information
When asked about where they obtained information on new drugs, NPs most frequently reported continuing
education (CE) activities and journal articles. Table 3.5 displays the frequency of other reported sources of new
drug information.
2020 AANP National Nurse Practitioner Sample Survey Results
10 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.1: Distribution of NPs by Race
Race
Percent
White
79.4
Black
8.1
Hispanic
5.0
Multiracial
2.3
Asian
4.3
Native Hawaiian or Pacific Islander
0.2
Native American or Alaska Native
0.5
Table 1.2: Distribution of NPs by Age Group
Age Group
Percent
< 30 years
1.5
30-34 years
8.6
35-39 years
14.6
40-44 years
12.6
45-49 years
13.4
50-54 years
12.6
55-59 years
12.9
60-64 years
14.3
65+ years
9.5
Table 1.3: Distribution of NPs by AANP Region
AANP Region
Percent
Region 1 (CT, ME, MA, NH, RI, VT)
7.2
Region 2 (NJ, NY, PR)
6.6
Region 3 (DC, DE, MD, PA, VA, WV)
11.1
Region 4 (KY, NC, SC, TN)
8.5
Region 5 (IL, IN, MI, MN, OH, WI)
14.1
Region 6 (AR, LA, OK, TX)
8.9
Region 7 (IA, KS, MO, NE)
5.0
Region 8 (CO, MT, ND, SD, UT, WY)
7.1
Region 9 (AZ, CA, HI, NM, NV, AS, GU)
11.0
Region 10 (AK, ID, OR, WA)
8.4
Region 11 (AL, FL, GA, MS, VI)
12.2
Table 1.4: Distribution of NPs by Census Region*
Region
Percent
Northeast (ME, NH, VT, MA, RI, CT, NY, NJ, PA)
18.0
Midwest (OH, MI, IN, WI, IL, MN, IA, MO, ND, SD, NE, KS)
21.2
South (DE, MD, VA, WV, KY, NC, SC, TN, GA, FL, AL, MS, AR, LA, TX, OK)
36.2
West (MT, ID, WY, CO, NM, AZ, UT, NV, CA, OR, WA, AK, HI)
24.6
*As defined by the U.S. Census Bureau
Table 1.5: Distribution of NPs by Military Status
Military Status
Percent
Currently on Active Duty
2.1
Previously on Active Duty
5.2
Not a Veteran
92.7
2020 AANP National Nurse Practitioner Sample Survey Results
11 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.6: Distribution of NPs by Initial NP Education Level
Initial NP Education
Percent
Master’s
85.9
Post-Master’s Certificate
9.2
Doctoral
4.9
Table 1.7: Distribution of NPs by Highest Degree Awarded
Highest Degree Awarded
Percent
Nursing Master’s
81.1
Non-nursing Master’s
1.0
DNP
14.7
Nursing PhD
1.6
Other Nursing Doctorate
0.4
Non-nursing Doctorate
1.3
Table 1.8: Distribution of NPs by Primary Certification Area
NP Certification
Family*
Adult*
Adult—Gerontology Primary Care*
Psychiatric/Mental Health
Acute Care
Pediatrics—Primary Care*
Adult—Gerontology Acute Care
Women's Health*
Gerontology*
Neonatal
Pediatrics—Acute Care
*Indicates a primary care certification
The sum of all percentages > 100% because some NPs have more than one certification
2020 AANP National Nurse Practitioner Sample Survey Results
12 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.9: Distribution of NPs by Advanced Certification Area
NP Certification
Hospice and Palliative Care
Wound Care
Oncology
Emergency
Diabetes Management—Advanced
Addictions-Advanced Practice
Dermatology
Occupational Health
Pediatrics—Primary Care Mental Health
Orthopedics
Nephrology
Genetics Advanced Nurse
School Health
Table 1.10: Distribution of NPs by Main Work Site Community Size
Community Size
Percent
Less than 2,500
4.2
2,500 to 9,999
11.3
10,000 to 49,999
22.2
50,000 to 249,999
31.4
250,000 to 999,999
19.6
1,000,000 or more
11.3
Table 1.11: Distribution of NPs by Years of NP Experience
Years of Experience
Percent
5 or fewer years
37.2
6-10 years
23.6
11-15 years
13.3
16-20 years
10.0
21 or more years
15.9
2020 AANP National Nurse Practitioner Sample Survey Results
13 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.12: Distribution of NPs by Main Work Site Setting
Work Setting
Percent
Hospital Outpatient Clinic
14.3
Private Group Practice
10.4
Hospital Inpatient Unit
10.0
Private Physician Practice
7.8
Urgent Care
4.3
Private NP Practice
3.8
Rural Health Clinic
3.4
Federally Qualified Health Center
3.3
Community Health Center
3.2
Employer/Corporate Clinic
2.9
Table 1.13: Distribution of NPs by Top NP Clinical Focus Area
Clinical Focus
Percent
Family*
19.2
Primary Care*
10.0
Urgent Care
5.7
Internal Medicine*
4.8
Psychiatry/Psychology
4.1
Cardiovascular
3.6
Geriatrics*
3.5
Women's Health/OB-GYN*
3.3
Oncology/Hematology
2.9
Pediatrics*
2.7
*Indicates a primary care clinical focus area
Table 1.14: Top NP Work Site Settings by Top NP Clinical Focus Areas
Work Setting
Percent
Clinical Focus
Percent
Hospital Outpatient Clinic
14.3
Family
12.3
Private Group Practice
10.4
Family
24.6
Hospital Inpatient Unit
10.0
Hospitalist
19.2
Private Physician Practice
7.8
Family
25.6
Urgent Care
4.3
Urgent Care
91.9
Private NP Practice
3.8
Family
43.7
Rural Health Clinic
3.4
Family
67.8
Federally Qualified Health Center
3.3
Family
54.6
Community Health Center
3.2
Family
48.3
Employer/Corporate Clinic
2.9
Family
36.7
2020 AANP National Nurse Practitioner Sample Survey Results
14 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.15: Median Hourly, Annual Base and Total Salary by Top 10 NP Work Site Settings
Hourly Rate
Annual Base Salary
Total Income
Work Setting
n
$
n
$
n
$
Hospital Outpatient Clinic
67
56.00
257
113,000
287
117,000
Private Group Practice
45
53.00
158
109,000
182
115,000
Hospital Inpatient Unit
75
62.00
185
120,000
223
125,000
Private Physician Practice
28
50.00
95
100,000
111
110,000
Urgent Care
57
60.00
35
112,000
76
120,000
Private NP Practice
**
**
19
97,000
63
120,000
Rural Health Clinic
21
53.00
51
107,000
66
110,000
Federally Qualified Health
Center
18
50.50
71
104,000
75
110,000
Community Health Center
17
58.00
64
110,000
69
112,000
Employer/Corporate Clinic
15
58.00
52
112,500
57
120,000
**Data unavailable
Table 1.16: Median Hourly, Annual Base and Total Salary by Top 10 NP Clinical Focus Areas
Hourly Rate
Annual Base Salary
Total Income
Clinical Focus
n
$
n
$
n
$
Family
121
52.00
266
107,000
349
110,000
Primary Care
59
60.00
154
106,000
196
115,000
Urgent Care
73
59.00
52
111,000
104
120,000
Internal Medicine
34
55.00
79
110,000
98
120,000
Psychiatry/Psychology
23
64.00
60
126,500
88
131,500
Cardiovascular
21
56.00
65
115,000
78
120,000
Geriatrics
19
55.00
63
107,000
72
118,000
Women's Health/OB-GYN
15
52.00
40
105,500
52
105,000
Oncology/Hematology
11
54.00
52
120,000
54
120,000
Pediatrics
**
**
28
104,500
30
110,000
**Data unavailable
2020 AANP National Nurse Practitioner Sample Survey Results
15 | Page
©
American Association of Nurse Practitioners, 2021
Table 1.17: Median Hourly, Annual Base and Total Salary by Primary Certification Area
Hourly Rate
Annual Base Salary
Total Income
NP Certification
n
$
n
$
n
$
Family*
451
57.00
1,010
110,000
1,292
115,000
Adult*
63
64.00
170
120,000
208
125,000
Adult—Gerontology Primary
Care*
42
60.00
118
110,000
142
116,000
Psychiatric/Mental Health
25
64.00
68
129,000
92
136,000
Acute Care
34
64.00
73
126,000
89
131,000
Pediatrics—Primary Care*
**
**
42
112,500
50
119,000
Adult—Gerontology Acute
Care
24
57.50
54
113,000
69
117,000
Women's Health*
12
55.00
26
108,500
38
112,000
Gerontology*
**
**
29
120,000
36
126,000
Neonatal
**
**
14
122,500
18
132,500
Pediatrics—Acute Care
**
**
12
128,500
12
135,000
*Indicates a primary care certification
**Data unavailable
Table 2.1: Percent of NPs Who Deliver Health Care by Patient Age Group
Patient Age Group
Percent
0–5 years
34.4
6–12 years
38.7
13–18 years
52.4
19–40 years
86.0
41–65 years
90.0
66–85 years
85.8
86 and older
67.1
Table 2.2: Percent of NPs Who See and Accept Patients by Payment Type
Payment Type
Percentage of NPs seeing
patients covered by…
Percentage of NPs accepting new
patients covered by…
Medicare
81.0
74.3
Medicaid
78.7
71.7
Commercial Insurance
83.7
79.0
Worker's Compensation
19.0
32.3
Uninsured—Cash Paying
51.5
68.3
Charitable/Uncompensated
22.3
32.4
Concierge/Direct Primary Care
4.4
12.8
2020 AANP National Nurse Practitioner Sample Survey Results
16 | Page
©
American Association of Nurse Practitioners, 2021
Table 2.3: Percent of NPs with High Influence on the Types of Patients Accepted in Their Practice
Insurance Type
Very or Extremely influential on whether work site accepts
patients covered by the following insurance types:
Percent of all NPs
Percent of NPs working
in Physician owned or
Private Group Practices
Percent of NP
Practice Owners
Medicare
11.0
10.9
83.0
Medicaid
11.3
10.7
81.1
Commercial Insurance
12.3
13.1
85.2
Worker's Compensation
7.8
7.0
73.7
Uninsured—Cash Paying
12.2
13.7
84.0
Charitable/Uncompensated
9.6
8.1
80.7
Concierge/Direct Primary Care
7.7
5.0
85.5
Table 2.4: Percent of NPs Treating Patients Below the Poverty Level by Community Size
Community Size
Percent
Less than 2,500
86.5
2,500 to 9,999
93.7
10,000 to 49,999
92.9
50,000 to 249,999
93.0
250,000 to 999,999
90.8
1,000,000 or more
91.0
Table 2.5: Average Number of Patients Seen per Day by NP Work Site Setting
Work Setting
Average Patients
Urgent Care
29
Retail Clinic
21
Private Physician Practice
19
Emergency Room
19
Telehealth
19
Correctional/Prison Facility
18
Private Group Practice
18
Community Health Center
17
Private NP Practice
17
Federally Qualified Health Center
17
2020 AANP National Nurse Practitioner Sample Survey Results
17 | Page
©
American Association of Nurse Practitioners, 2021
Table 2.6: Average Number of Patients Seen per Day by NP Clinical Focus Area
Clinical Focus
Average Patients
Urgent Care
26
Dermatology
26
Nephrology
21
Orthopedics
20
Emergency
20
Pediatrics
19
Women's Health/OB-GYN
19
Pain Management
19
Wound Care
18
Urology
18
Table 2.7: Frequency of Patients Provided NP Services
How many patients do you provide the following services for?
Most
Some
Few
None
Coordination of Care
60.1
26.0
9.4
4.5
Diagnosis and Management of Acute Conditions
64.9
25.1
6.6
3.4
Diagnosis and Management of Chronic Conditions
65.0
19.6
9.5
5.9
Education and Counseling
85.4
10.9
2.4
1.3
Patient History and Physicals
39.1
20.5
12.9
27.5
Preventive Screening and Immunizations
47.3
18.1
15.8
18.8
Order, Perform and Interpret Labs, X-rays and Diagnostics
78.4
15.1
3.6
2.9
Perform Procedures
24.1
31.0
24.3
20.5
Table 2.8: Percent of NPs Consulting with Other Health Care Providers
For approximately what percentage of your
patients do you do the following:
<1%
Patients
1-24%
Patients
25-59%
Patients
60-99%
Patients
100%
Patients
Verbally Consult with Physician in NP Focus Area
29.8
50.8
9.7
5.9
3.8
Verbally Consult with Physician Specialist
36.1
49.2
8.8
4.0
1.9
Request Referral to Physician in NP Focus Area
53.1
35.6
8.3
2.2
0.8
Request Referral to Physician Specialist
13.6
57.5
23.8
4.5
0.7
Request Referral to Another NP
69.5
25.6
4.0
0.7
0.3
Request Referral to Another Provider
25.4
54.8
15.7
3.5
0.6
2020 AANP National Nurse Practitioner Sample Survey Results
18 | Page
©
American Association of Nurse Practitioners, 2021
Table 2.9: Top Three NP Referrals by Top 10 NP Work Site Settings
Work Setting
Health Professional
Percent
Hospital Outpatient Clinic
Physician Specialists
80.5
Physical Therapists
73.1
Dietitians/Nutritionists
69.9
Private Group Practice
Physician Specialists
82.0
Physical Therapists
80.5
Dietitians/Nutritionists
71.5
Hospital Inpatient Unit
Physician Specialists
78.0
Physical Therapists
76.6
Social Workers
69.3
Private Physician Practice
Physician Specialists
83.2
Physical Therapists
78.6
Psychologists
62.7
Urgent Care
Physician Specialists
80.0
Physical Therapists
72.2
Physician Primary Care
65.9
Private NP Practice
Psychologists
76.0
Physical Therapists
73.8
Physician Specialists
72.1
Rural Health Clinic
Physical Therapists
88.3
Physician Specialists
86.9
Psychologists
84.1
Federally Qualified Health
Center
Physical Therapists
86.6
Physician Specialists
82.4
Podiatrists
81.4
Community Health Center
Physician Specialists
82.4
Physical Therapists
80.9
Psychologists
78.5
Employer/Corporate Clinic
Physical Therapists
83.1
Physician Specialists
80.8
Psychologists
70.8
2020 AANP National Nurse Practitioner Sample Survey Results
19 | Page
©
American Association of Nurse Practitioners, 2021
12.7%
17.5%
21.0%
23.2%
28.2%
30.9%
36.2%
42.3%
42.5%
43.7%
43.9%
44.5%
45.5%
46.7%
46.7%
50.4%
51.7%
53.0%
53.9%
53.9%
54.1%
54.6%
55.2%
55.6%
57.1%
57.4%
57.6%
58.4%
58.9%
59.9%
60.1%
60.3%
61.1%
62.4%
62.5%
64.1%
64.5%
65.3%
65.5%
66.0%
66.3%
66.7%
67.2%
69.4%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%
Prenatal care
Pregnancy
HIV/AIDS
Other
Substance Use Disorder/Opioid Use Disorder
Epilepsy
Menopause
BPH
Dementia
CAD/IHD/Angina
Fibromyalgia/Myalgia
Arrthythmias
Heart failure
Lacerations/Contusions
Acne/Rosacea
COVID-19
Arthritis (OA and RA)
COPD
Vaginitis
Obesity
Acute sprain/Strain
Sprains/Strains
Otitis media
Thyroid disease
Dermatitis
Hyperlipidemia
Allergic respiratory illness
Insomnia
Influenza
Dizziness/Vertigo
Diabetes
Asthma
Sinusitis
Anemia
Acute lower respiratory illness
Back pain or neck pain
Headache/Migraine
Depression
Acute upper respiratory illness
Hypertension
GERD/Heartburn
UTI
Anxiety
Abdominal pain
Percent of NPs
Diagnoses
Figure 2.1: Percent of NPs by Diagnoses Treated
2020 AANP National Nurse Practitioner Sample Survey Results
20 | Page
©
American Association of Nurse Practitioners, 2021
‡1.4%, †1.7%
*see Table 1.13 for primary care clinical focus designations
2020 AANP National Nurse Practitioner Sample Survey Results
21 | Page
©
American Association of Nurse Practitioners, 2021
‡0.7%, †1.6%, *1.8%, **3.0%
2020 AANP National Nurse Practitioner Sample Survey Results
22 | Page
©
American Association of Nurse Practitioners, 2021
Table 3.1: Mean and Median Prescriptions per Day by Top 10 NP Certification Areas
NP Certification
Percent
Prescribing
Prescriptions/Day
Mean
Median
Family*
97.6
22
15
Adult*
94.5
18
10
Adult—Gerontology Primary Care*
96.3
17
10
Psychiatric/Mental Health
99.2
27 20
Acute Care
95.6
19
10
Pediatrics—Primary Care*
97.2
10
10
Adult—Gerontology Acute Care
97.0
17
10
Women's Health*
98.4
21
10
Gerontology*
97.2
12
10
Hospice and Palliative Care
100.0
12
8
*Indicates a primary care certification
Table 3.2: Prescribing by Top 20 NP Work Site Settings
Work Setting
Percent
Prescribing
Prescriptions/Day
Mean
Median
Hospital Outpatient Clinic
97.7
18
10
Private Group Practice
98.5
23
15
Hospital Inpatient Unit
97.2
15
10
Private Physician Practice
99.4
27
20
Urgent Care
99.1
25
20
Private NP Practice
98.4
29
20
Rural Health Clinic
100.0
27
20
Federally Qualified Health Center
100.0
32
20
Community Health Center
100.0
29
20
Employer/Corporate Clinic
100.0
22
20
Other Clinic (e.g., free clinic, walk-in clinic)
97.0
21
15
Emergency Room
98.8
21
20
VA Facility
99.2
32
30
Behavioral Health/Addiction
97.6
22
15
Hospital Surgical Settings
93.2
9
10
Hospice/Palliative Care
100.0
10
7
Long-term Care Facility
100.0
14
10
Skilled Nursing Facility
100.0
13
10
Correctional/Prison Facility
98.1
28
20
College Student Health
100.0
8
10
2020 AANP National Nurse Practitioner Sample Survey Results
23 | Page
©
American Association of Nurse Practitioners, 2021
Table 3.3: Prescribing by Community Size
Community Size
Percent
Prescribing
Prescriptions/Day
Mean
Median
Less than 2,500
98.5
21
20
2,500 to 9,999
97.7
23
15
10,000 to 49,999
98.1
24
20
50,000 to 249,999
97.0
21
10
250,000 to 999,999
97.0
18
10
1,000,000 or more
95.5
15
10
Table 3.4: Top 10 Agents Prescribed Regularly (>15 Times per Week) by NPs
Drug
Percent
Antihypertensives
24.8
Dyslipidemic Agents
18.0
Diabetic Agents, Other
16.3
Analgesics, NSAID
15.8
Vaccines/Immunizations
15.6
Antidepressants
14.3
Antibiotics
12.2
GERD/PUD Agents
12.1
Diabetic Agents, Insulin
12.0
Diuretics
11.8
Table 3.5: Sources of Information on New Drugs
Source
Percent
Continuing Education Activities
94.3
Journal Articles
72.5
Colleagues
67.0
Pharmaceutical Information Pharmacist
62.7
Pharmacist
51.9
Packaged Product Information
29.1
Journal Advertisements
18.0
Media
13.6
2020 AANP National Nurse Practitioner Sample Survey Results
24 | Page
©
American Association of Nurse Practitioners, 2021
0
5
10
15
20
25
30
35
<5 5-9 10-14 15-19 20-24 25-29 30 or more
5
11
19
22
26
27
32
Average Rx Per Day
Average Patients Per Day
Figure 3.1: Mean Prescriptions Written/Refilled per Day by Patient Volume
2020 AANP National Nurse Practitioner Sample Survey Results
25 | Page
©
American Association of Nurse Practitioners, 2021