What are the Best States for NPs & Other APRNs (2021-22)?
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Nurse practitioners belong to the second-fastest-growing occupation in the nation. According to the Bureau of Labor Statistics (BLS 2021), the NP workforce is projected to grow by 52 percent between 2019 and 2029, adding over a quarter-million jobs. NPs will also earn an average wage of $114,510 per year (BLS May 2020), which is approximately double the national average.
But national statistics can be misleading, especially in a data set that extends across a country with the size and population of the US. NPs and APRNs in Tennessee, for example, will earn 30 percent less, on average, than their counterparts in California, and 15 percent less than their counterparts in Wyoming.
But what good is a high salary if you can’t find a job? Tennessee is projected to grow its workforce by 34.7 percent, and Wyoming by 30 percent, which seems a negligible difference, until you consider that Wyoming only averages 30 job openings for NPs each year, while Tennessee offers an average of 730.
Methodology: The Best States for NPs and APRNs
If that sounds confusing, don’t worry. We’ve crunched the numbers for you. In ranking the best states for NPs and other APRNs, we utilized the following sources—the latest information available as of July 2021:
- Job Growth Data: Long-Term Occupational Projections (2018-2028) from Projection Central that accounts for states’ projected workforce percentage increase and annual average job openings
- Salary Data: State Occupational Employment and Wage Estimates (May 2020) from the Bureau of Labor Statistics (BLS) that cover average annual wages
- Regulatory Data: Classification as restricted practice, reduced practice, and full practice authority as defined by either the American Association of Nurse Practitioners (AANP) or localized NP associations
From the aggregated data, we ranked each geographic area from best to worst (1-50), then weighted those rankings as follows:
- 25 percent (projected job growth by percentage)
- 25 percent (average annual job openings)
- 50 percent (projected annual salary)
We distributed our weight between job growth by percentage and job growth by annual job openings in order to better capture the actual availability of opportunities for new NPs, without completely discounting low-population states.
Each state’s final score, with the lowest being best, determined its overall ranking. (Note that Louisiana did not have official job growth data for NPs and APRNs, and was excluded from our rankings, but the District of Columbia has been included in its place.)
While not included as a major weight within the rankings, a state’s regulatory status regarding the NP and APRN practice environment remains an important factor to consider. Restricted and reduced practice states with collaborative agreements may present local NPs and APRNs with financial burdens that cut into their annual salary.
We’ve used regulatory status as a tiebreaking metric, and included information on each state’s practice environment in our master database below.
Do note that our regulatory classifications differ slightly from the official AANP website. Where they do, we’ve added an asterisk in the master database. This asterisk is meant to denote states in which:
- Full practice authority bills have been passed, and are yet to go into full effect
- Full practice authority bills have been passed, but too recently to be reflected on AANP’s website
- Full practice authority is conditioned upon a certain number of years of additional experience in the field
Ultimately, the regulatory landscape is constantly shifting, with nearly every restricted and reduced practice state introducing a new full practice authority bill each year. NPs and APRNs are advised to stay updated with AANP and local state NP associations for the latest regulatory news, and factor that into their final calculations just as one would cost of living.
“Best” will always be a somewhat subjective term. But below you’ll find the most pertinent data points for NPs and APRNs in each state, so you can make your own determinations.
Top Ten States for NPs & Other APRNs in 2021-2022
#1: New York
The Empire State is the nation’s best when it comes to annual job openings for NPs and APRNs, with an estimated 1,640 positions available every year. It’s also one of the most high-paying environments: NPs in New York earn an average of $126,440 per year.
New York has not yet adopted full practice authority for its NPs, and is still classified as a reduced practice state. However, in response to the Covid-19 pandemic, Executive Order 202.10 temporarily granted the state’s NPs full practice authority. Originally set to expire in April of 2020, it’s been repeatedly extended, and will last until at least July 5, 2021.
Even without factoring in a long coastline, temperate climate, and the Rocky Mountains, California still comes in near the top of our rankings for NPs. It’s the highest paying state on the list, with NPs earning an average of $145,970 per year, which is nearly 50 percent more than the lowest-paying state. It’s also set to grow its NP workforce by 30.5 percent, which amounts to a lot in the nation’s most populous state: there are an average of 1,390 new NP job openings every year.
California is still listed as a restricted practice state by AANP, but Assembly Bill 890 passed in October of 2020 and will grant the state’s NPs full practice authority by 2023.
#3: New Jersey
One of the healthiest states in the nation, according to US News and World Report, New Jersey is also the second-highest paying state for NPs, offering an average wage of $130,890 per year. There’s room for growth, too: the state is projected to increase its NP workforce by over 28 percent, contributing to the 560 average annual job openings for advanced practice nurses.
New Jersey is still a reduced practice state, but its 10,000 advanced practice nurses are fighting for change through an active network of advocacy groups like the Forum of Nurses in Advanced Practice (FNAP) and the New Jersey State Nurses Association (NJSNA).
Washington ARNPs are the third-highest paid in the US, earning an average of $126,480 per year. They’re also projected to grow their ARNP workforce by 28.5 percent, and boast an average of 480 ARNP job openings per year.
And that Pacific Northwest air tastes even better for the state’s ARNPs, who can breathe a little easier knowing they have full practice authority. State organizations like the ARNPs United of Washington State (AUWS) aren’t finished advocating for the profession, though: they’re pushing further, lobbying for equal reimbursement and insurance expansion.
Texas is the only restricted practice state to make our top ten. But what the state lacks in regulatory freedom, it compensates for with size. Texas is projected to grow its NP workforce by 31.9 percent and is home to an estimated 1,170 annual job openings for NPs.
The cost of living in Texas is lower than many of the states ranked above it, too, meaning that a Texan NP’s annual average salary of $116,700 may have a significantly higher purchasing power.
Arizona is growing its NP workforce faster than any other state, with a 50.9 percent projected growth rate. The state has an average of 200 new NP annual job openings, and the pay is good, too: the average NP in Arizona earns $117,480 per year. Full practice authority adds to Arizona’s bright outlook for NPs, as does its average of 300 days of sun per year.
Oregon ticks all the boxes for NPs. It’s set to grow its NP workforce by 32 percent and is home to an average of 210 annual NP job openings. Oregonian NPs also earn a competitive average salary of $118,600 per year.
Furthermore, the state has a history of progressive health-related regulation: it has compassionate end-of-life policies, it was the first state to decriminalize marijuana, and it extends full practice authority to its NPs.
Though it’s sometimes referred to by its nickname, America in Miniature, there’s nothing tiny about Maryland when it comes to its NP workforce. The state has an average of 390 annual job openings for NPs each year and is set to grow the NP workforce by 34.9 percent.
The pay is competitive, with Maryland NPs earning an average of $115,420 per year. None of that salary will go to a supervising physician, either, as the state’s NPs have full practice authority.
Massachusetts is one of the highest paying states for NPs, with an average annual salary of $126,050. And while its NP workforce is only projected to grow by 16.2 percent, that still amounts to an average of 540 annual job openings. For one of the oldest states in the union, it’s remarkably progressive, and Massachusetts NPs enjoy full practice authority.
Other states look to Massachusetts to lead the way on health reform, and it continues to do so: the state’s NPs are pushing for equal access to primary care as well as mental healthcare.
The fifth most populous state in the country, Illinois is projected to grow its NP workforce by 31.1 percent and offers an average of 760 NP job openings every year. Illinois also offers its NPs a slightly above-average salary of $112,060 per year.
While Illinois is still a reduced practice state by AANP standards, it does have a clear path forward: NPs with 4,000 hours of clinical experience can apply for a full practice authority license.
Data Set: Best States for NPs & Other APRNS (2021-2022)
|Job Growth Projection (Total)||Job Growth Projection (Percent)||Average Annual Job Openings||Regulatory Status|
|District of Columbia||$116,150||210||24.1||70||Full|
Matt Zbrog is a writer and researcher from Southern California, and he believes a strong society demands a stronger healthcare system. Since early 2018, he’s written extensively about emerging topics in healthcare administration, healthcare research, and healthcare education. Drawing upon interviews with hospital CEOs, nurse practitioners, nursing professors, and advocacy groups, his writing and research are focused on learning from those who know the subject best.