Background. With over 10 million patient encounters a year at Texas Medical Center (TMC), Advanced Practice Providers (APPs) are being incorporated into health care delivery models. Moving beyond the narrow “scope of practice” debates that frequently surface when talking about APPs, this inquiry instead seeks to broaden the discussion and take a more comprehensive view of how APPs are being incorporated into health care delivery models that span across several TMC institutions.

Methods. This study uses a thematic analysis study design to analyze structured interviews collected from a small convenience sample of Advance Practice Provider Program Directors at Texas Medical Center. A semi-structured interview guide was pilot tested for clarity and relevance of the questions.

Results. The iterative thematic analysis approach saw four main themes emerge: 1) APP value to the team efficiency, 2) APP benefit to billing, productivity, and improved quality metrics, 3) variation in APP orientation and utilization, and 4) projected future growth of APPs. In addition, 4 institutions provided quantitative data from 2011 and 2016 about the number of APPs.

Conclusions. The quantitative data analysis only further demonstrates the organic growth and presumed value equation that tilts towards APPs being an important part of the evolving healthcare workforce both now and in the years to come. This numeric information is consistent with the analyses and projections found in the relevant workforce reports periodically conducted and issued by the Health Resources Services Administration (HRSA).