Updated for 2025
For nearly six decades, Nurse Practitioners (NPs) have redefined what it means to deliver exceptional, patient-centered care. Blending advanced clinical expertise with a holistic focus on disease prevention and health management, NPs bring a unique and invaluable perspective to health care that is rooted in compassion, education, and evidence-based practice.
Today, NPs serve in every corner of the healthcare system—hospitals, clinics, schools, and private practices—meeting patients where they are and ensuring access to quality care for all. With 87% of NPs nationally prepared in primary care, these clinicians are often the first point of contact for individuals and families seeking trusted, comprehensive health management.
As one of the fastest-growing sectors of the primary care workforce, NPs are leading the way in addressing provider shortages, improving outcomes, and expanding access to care across communities. Their commitment to patient advocacy and clinical excellence continues to shape the future of healthcare delivery in the United States.
Let’s take a moment to look back at how this transformative profession began and celebrate how far it’s come since 1965.
The History of Nurse Practitioners in the U.S.
1965
The first NP program was founded by Loretta Ford, EdD, PNP, FAAN, and Henry Silver, MD, at the University of Colorado, as a response to the shortage of primary care providers arising from the expansion of coverage by Medicare and Medicaid to include low-income women, children, the elderly, and people with disabilities.
1974
The American Nurses Association (ANA) helped legitimize the role of NPs by establishing the Council of Primary Care Nurse Practitioners, which created an early description of an NP’s duties. To further standardize the duties of NPs, the ANA began offering NP certification exams in 1977.
1979
There are approximately 15,000 NPs in the U.S.
1985
The American Academy of Nurse Practitioners was established, gaining 100 members in its first year.
1987
The federal government has spent $100 million on NP education.
1989
NP leaders worked with Congress to pass the Omnibus Reconciliation Act of 1989, which created limited reimbursement for NPs.
1993
AANP forms the American Academy of Nurse Practitioners Certification Program.
1995 – 1999
The number of NPs increased from 40,000 to more than 60,000, and the number of NP education programs continued to outnumber all other nursing specialties.
2004
National Nurse Practitioner Week, held annually in November, is recognized in a proclamation by U.S. Congress.
2010
AANP celebrates its 25th anniversary and participates at a meeting with White House Office of Health Reform to review the primary care perspective on preventive care, access, coordinated primary care, quality of care, payment and the need to recognize all primary care providers as solutions to the healthcare crisis.
2022-2023
The number of nurse practitioners (NPs) in the U.S. increased by 8.5%, growing from 355,000 in 2022 to 385,000 in 2023.
2024
Employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 35% from 2024 to 2034.
Senate Bill 196, otherwise known as Global Signature Authority, was passed by the Ohio legislature and subsequently signed by Governor DeWine in December 2024.
2025
The introduction of Senate Bill 258 (the “Better Access to Healthcare Act”) in the Ohio Senate, along with companion House legislation House Bill 449 and House Bill 508, marks a historic opportunity to retire the long-standing Standard Care Arrangement (SCA) requirement for APRNs.
One Voice for Ohio’s APRNs: Leading the Path to Retire the SCA
With over 431,000 licensed Nurse Practitioners delivering nearly 1 billion patient visits annually across the United States, the value of these clinicians is undeniable. As 27 states, the District of Columbia, and territories have retired the Standard Care Arrangement, patients are gaining full and direct access to the outstanding care provided by NPs.
At the same time, in Ohio, OAAPN stands as the collective voice for more than 30,000 Advanced Practice Registered Nurses (APRNs) — including Nurse Practitioners, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists and Certified Nurse Midwives.
Now is the moment for Ohio to move boldly forward. The introduction of Senate Bill 258 (the “Better Access to Healthcare Act”) in the Ohio Senate, along with companion House legislation House Bill 449 and House Bill 508, marks a historic opportunity to retire the long-standing Standard Care Arrangement (SCA) requirement for APRNs.
This step is not about expanding scope beyond licensure, education or certification—it’s about removing an outdated, unfunded contract requirement that limits Ohio’s highly trained APRNs from practicing to the full extent of their training and capabilities.
By eliminating the SCA, Ohio can:
- Expand patient access to high-quality, patient-centered care, especially in underserved and rural communities.
- Reduce unnecessary administrative burdens and delays in treatment, allowing APRNs to practice more efficiently and focus on patient care.
- Strengthen our state’s healthcare infrastructure, enabling APRNs to fully contribute their education, training, and national certification toward improving outcomes and caring for more Ohioans.
OAAPN is committed to supporting this legislative progress, advocating for evidence-based policies, and ensuring that APRNs in Ohio can practice at the top of their licensure. Together, we will continue to work with policymakers, patients, and allied healthcare professionals to ensure that Ohio leads the way in delivering accessible, high-quality care.