What You Should Know
- According to a new report from CHG Healthcare, advanced practice providers (APPs)—including NPs, PAs, and CRNAs—have shifted from temporary coverage to foundational infrastructure, with 92% of surveyed healthcare facility leaders rating APPs as “very” or “extremely” important to workforce strategy.
- The report, Advanced Practice Provider Workforce Trends Report, reveals that nearly all healthcare facilities (97%) plan to maintain or increase APP utilization in 2026, transitioning from rapid expansion to steady operational reliance.
- APPs deliver simultaneous gains in efficiency and expansion, with 89% of facilities reporting positive organizational growth and 85% reporting cost containment.
- Certified Registered Nurse Anesthetists (CRNAs) are the most difficult APP role to fill nationally (30%), escalating to 49% in rural facilities where anesthesia coverage is critical to surgical operations.
- A widening geographic divide exists in contingent staffing: urban health systems are expanding APP locum tenens usage (23%), while rural systems are pulling back on locums (25%) due to financial constraints despite reporting the highest strategic reliance on APPs (58%).
CHG Healthcare Data Charts the Rise of APPs as Core Infrastructure
The hospital executive, clinical operations, and health system recruitment sectors are undergoing a structural shift: moving away from viewing Advanced Practice Providers (APPs) as emergency stopgaps toward embedding them as core workforce infrastructure. According to CHG Healthcare’s Advanced Practice Provider Workforce Trends Report—based on a national survey of 327 healthcare facility leaders conducted in Q4 2025—92% of respondents now rate APPs as “very” or “extremely” important to their overall strategy, up from 89% in the prior wave.
Furthermore, 97% of facilities plan to maintain (45%) or increase (51%) APP utilization in 2026, while only 1% report plans to reduce usage. This stabilization indicates that healthcare systems have passed the initial expansion phase driven by pandemic shortages and are now optimizing structured APP care models.
3 Critical Operational Dynamics Governing APP Strategy
The CHG Healthcare survey highlights three critical operational dynamics governing APP strategy across urban, suburban, and rural settings:
- Simultaneous Cost Containment and Growth: In standard workforce models, cost reduction and volume expansion pull in opposite directions. However, 89% of leaders report a positive impact on organizational growth from APPs, alongside an 85% positive impact on operating costs. Additionally, 94% report expanded patient access to care and 92% note improvements in throughput.
- Severe CRNA Recruitment Pressures: Certified Registered Nurse Anesthetists (CRNAs) represent the single hardest APP role to fill nationally at 30%. In rural markets, this pressure spikes to 49%, directly threatening operating room capacity and surgical revenue in hospitals that rely on CRNA-led anesthesia models.
- The Urban-Rural Contingent Staffing Divide: Urban systems are scaling APP locum tenens usage (23% plan to increase vs. 12% reducing) to maintain access. Conversely, 25% of rural facilities plan to cut APP locums usage—even though 58% of rural leaders rate APPs as “extremely important” (the highest of any region). Operating on thin margins, rural hospitals often treat locums spending as a discretionary cost rather than essential access infrastructure.
- Alleviating Physician Burnout: While 80% of facilities report positive effects on burnout, it remains among the lowest-rated dimensions. Maximum burnout reduction occurs in top-of-license team models where APPs manage routine cases independently, allowing physicians to focus on complex clinical presentations.
“Advanced practice providers are closing critical gaps and driving better patient outcomes across health systems,” stated Chris Purkey, President of CompHealth’s APP division at CHG Healthcare.
