Acute Care AG-ACNP vs. Primary Care AG-PCNP

Choosing an NP specialization can be challenging, especially when deciding between acute care adult-gerontology (AG-ACNP) and primary care adult-gerontology (AG-PCNP). Both AG-NP tracks offer opportunities to support older adults with their holistic healthcare needs, and each specialization has unique requirements and certifications. This guide outlines the AG-ACNP and AG-PCNP pathways so aspiring adult-gerontology nurse practitioners (NPs) can decide which nursing specialization is right for them. 

The adult-gerontology field focuses on providing medical care for older adults, a demographic whose medical care demands are expected to increase in the coming years. According to the U.S. Department of Health and Human Services, the population of adults age 65 and older will increase from 16 percent in 2019 to 21.6 percent in 2040. 

Fortunately, nurse practitioners, the fastest-growing occupation in the nation, are poised to keep pace with increased patient demand. According to the US Bureau of Labor Statistics (BLS), nurse practitioner job openings nationally will grow by 46 percent from 2021 to 2031, creating 118,600 new jobs in the same period.  

There are two adult-gerontology specializations: acute care and primary care. In general, acute care is focused on illness and injuries, and primary care focuses on wellness and prevention.

Acute care adult-gerontology nurse practitioner (AG-ACNP) curricula concentrate on caring for acutely ill patients with complex medical issues. Coursework typically includes diagnostic reasoning, pharmacology, pathophysiology, and advanced physical assessment skills. Acute care NPs diagnose and treat acute illnesses, injuries, and disabilities in adults older than 18 in hospitals or urgent care clinics. AG-ACPNs provide education on preventive health measures to help patients manage chronic conditions or prevent future illness or injury. 

Primary care adult-gerontology nurse practitioner (AG-PCNP) program curriculum focuses on providing comprehensive healthcare services to adults aged 19 and above. Coursework typically includes health promotion, disease prevention, health education/counseling, chronic illness management, and differential diagnosis. 

Primary care NPs diagnose and treat common illnesses; provide preventive services; coordinate patient care with other providers; order lab tests; prescribe medications; conduct physical exams; educate patients about their health needs; and refer patients to other healthcare providers when necessary. Many AG-PCNPs work in clinics and nursing homes.

Both acute care AG-ACNPs and primary care AG-PCNPs are excellent career paths for registered nurses looking for a career change or current advanced practice registered nurses (APRNs) wanting to expand their expertise. Some programs combine two specialty tracks, such as the dual role MSN program offered by the University of South Alabama, which provides a dual role specialization family and adult-gerontology NP program. 

Each NP program offers different educational benefits that prepare students for successful adult gerontology nurse practitioners (AGNPs) careers. Please see our guide to online adult-gerontology NP programs for a comprehensive list of adult-gero graduate education options.  

Ultimately it is up to each aspiring NP student to decide which adult-gerontology specialization is right for them based on their goals and interests. To help simplify the decision, here is a side-by-side chart comparing adult-gerontology specializations in acute care and primary care. 

Acute Care NP (AG-ACNP)Primary Care NP (AG-PCNP)


An adult-gerontology acute care NP (AG-ACNP) is an advanced practice (APRN) role. AG-ACNPs provide preventative, diagnostic, and therapeutic services to younger and older adults, including seniors and those with acute and chronic conditions.

An adult-gerontology primary care NP (AG-PCNP) specializes in healthcare for adults as an APRN. AG-PCNPs provide primary care by assessing, diagnosing, and managing complex and urgent medical conditions for patients aged 18 and older.

Occupational Demand

46 percent for all NPs (much faster than the national average) from 2021-2031 (BLS 2022)

46 percent for all NPs (much faster than the national average) from 2021-2031 (BLS 2022)

Number Employed258,230 (BLS May 2022)258,230 (BLS May 2022)
Degree & Certificate Programs
  • Master of Science in Nursing (MSN)
  • Post-Master’s NP Certificates
  • Doctorate of Nursing Practice (DNP)
  • Master of Science in Nursing (MSN)
  • Post-Master’s NP Certificates
  • Doctorate of Nursing Practice (DNP)
Degree/Certificate Specialization Track

Adult-Gerontology Acute Care NP (AG-ACNP)

Adult-Gerontology Primary Care NP (AG-PCNP)

Admission Requirements
  • BSN (bachelor of science in nursing)
  • RN license
  • 1-2 years of experience in adult-gerontology acute care
  • BSN (bachelor of science in nursing)
  • RN license
  • 1-2 years of experience in adult-gerontology primary care
Sample Degree Programs

Seton Hall University – Online MSN in adult-gerontology: acute care and primary care

University of Connecticut – Online MSN, Post-Master’s Certificate, and BSN-DNP programs in adult-gerontology: acute care

Maryville University – Online MSN, Post-Master’s Certificate, and DNP programs in adult-gerontology: primary care University of Cincinnati – Online MSN and Post-Master’s Certificate in adult-gerontology: primary care

Work Environments

Clinics and services:

  • Cardiology
  • Hospice
  • Intensive care
  • Oncology
  • Palliative care
  • Pulmonary

Clinics and services:

  • Dermatology
  • Gastrointestinal
  • Long-term care
  • Neurology
  • Occupational health
  • Rheumatology
Typical Responsibilities
  • Provide acute care for adult and gerontological populations
  • Assess acutely or chronically ill patients in any care setting
  • Develop sophisticated treatment plans
  • Follow effective therapeutic strategies for short-term crises
  • Interpret labs and medical tests
  • Long-term care management of patients on an individual or population level
  • Provide holistic primary care to diverse populations
  • Administer exceptional care for different age groups and chronic ailments
  • Create individualized plans to provide optimum health outcomes for patients
  • Diagnose and manage of medically complex conditions
  • Educate patients on routine and advanced treatment plans
  • Implement preventive health measures

Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC®)

Adult-Gerontology Acute Care Nurse Practitioner (ACNPC-AG®)

Adult-Gerontology Primary Care Nurse Practitioners (A-GNP)

Adult-Gerontology Primary Care Nurse Practitioner Certification (AGPCNP-BC®)

Average Annual Salary

$124,680 per year (BLS May 2022)

$96,063 per year ( 2023)

$124,680 per year (BLS May 2022)

$90,101 per year ( 2023)

Professional Organizations

American Association of Critical-Care Nurses (AACN)

American Nurses Credentialing Center (ANCC)

Gerontological Advanced Practice Nurses Association (GAPNA)

American Academy of Nurse Practitioners (AANP)

American Nurses Credentialing Center (ANCC)

Gerontological Advanced Practice Nurses Association (GAPNA)

Bottom Line

Adult-gerontology acute care is focused on managing acute episodes presenting in adult or geriatric patients across a variety of medical conditions or wounds.

Adult-gerontology acute care involves the active management of illnesses throughout the lifespan.

Adult-gerontology primary care is focused on prevention, health promotion, and identification of health problems in adult populations.

Adult-gerontology primary care emphasizes prevention and referrals if needed.

Rachel Drummond, MEd

Rachel Drummond, MEd


On, Rachel Drummond has leveraged her extensive background in education and mindfulness to provide valuable insights to nursing professionals since 2020. She explores how mindfulness and movement can be incorporated into the demanding routines of nurses, emphasizing the importance of mental and physical well-being for increased resilience and effectiveness in the challenging field of nursing.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.

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