The rise of advanced registered nurse practitioners and physician assistants and the impact on the health care labor market

There has been a dramatic increase in the authority granted to advance registered nurse practitioners (ARNP) and physician assistants (PA) through changes in regulation. This "expanded" authority has changed who can provide medical services and has weakened the monopoly physicians have traditionally held over the provision of medical services. This dissertation examines the impact of these regulatory changes on the labor markets of ARNPs, PAs, and physicians.;Two measures of the labor market for each ARNPs, PAs, and physicians are examined: provider incomes and provider populations. The changes in regulation have varied by occupation, state, and year, providing a significant level of variation. This variation is exploited to empirically measure the individual and collective impacts of changes in ARNP authority and PA authority on practitioner incomes and populations.;It is found that changes in ARNP and PA regulatory authority do impact the labor markets of all three practitioner categories. ARNPs having greater practice authority brings PA and physician incomes down, all else equal. PAs having increased measures of authority has differential effects on ARNP and physician incomes depending on the type of expanded authority. PAs having expanded practice authority tends to increase their own incomes and that of physicians while tending to push ARNP incomes down.;Expanded authority for PAs and ARNPs is also found to impact provider populations. PA expanded authority has differential impacts on physician populations while ARNPs having expanded regulatory authority decreases physician population levels, all else equal. ARNP population levels tend to fall with both ARNP and PA authority while PA population levels tended to increase with expanded ARNP and PA authority.;Keywords. Health Labor, Physician, Regulation, Physician Assistant, Nurse Practitioner.