{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:47:29Z","timestamp":1792277249329,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Nurse practitioners and physician assistants form a growing advanced practice provider (APP) group. We aim to analyze the trends and types of services provided by APPs in otolaryngology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use Files, 2012\u20102017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Medicare database was searched for 13 commonly used otolaryngology\u2010specific <jats:italic>Current Procedural Terminology<\/jats:italic> (<jats:italic>CPT<\/jats:italic>) codes, and 10 evaluation and management (E\/M) codes were evaluated by provider type. Changes in code utilization were compared between physicians and APPs over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2012 to 2017, there was a 51% increase in the number of otolaryngology APPs, compared to a 2.2% increase in physician providers. APPs increased their share of new and established patient visits from 4% to 7%d 11% to 15%, respectively. There was not a significant difference over time in number of patient visits performed annually per provider according to provider type. The increase in number of APP vs physician providers was significantly greater for every procedure except for balloon sinus dilation and tympanostomy tube placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Due to increasing numbers, APPs are accounting for more patient visits and procedures over time. The physician workforce and the numbers of procedures performed per physician have remained relatively stable from 2012 to 2017. Increasing complexity of patients seen and a broader range of procedures offered by work\u2010experienced or postgraduate\u2010trained APPs may further improve access to health care in the face of possible physician shortages.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820971186","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T04:05:30Z","timestamp":1606190730000},"page":"69-75","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Advanced Practice Providers Utilization Trends in Otolaryngology From 2012 to 2017\u00a0in the Medicare Population"],"prefix":"10.1002","volume":"165","author":[{"given":"Marshall","family":"Ge","sequence":"first","affiliation":[{"name":"Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee\u2010hong","family":"Kim","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Shintani","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery McGaw School of Medicine of Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianna","family":"Paul","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Park","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyi","family":"Su","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth H.","family":"Ference","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892420905250"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489416668193"},{"key":"e_1_2_8_4_1","unstructured":"State Practice Environment.2019. 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