Advanced practice clinicians (APCs)—nurse practitioners and physician assistants—that are in the 90th percentile of community health centers (CHCs) provide about 1,840 adjusted-visits per year; whereas APCs in the 10th percentile CHCs provide about 978 adjusted-visits per year. Several important conditions were found among high productivity CHCs, including scheduling APCs and physicians for the same number of visits, parity in terms of any financial incentives, and formal education programs for new APCs during onboarding/transition to practice.

This article explores why the productivity of APCs varies across CHCs, as measured in their marginal contribution to overall patient visits.