Nearly 33% of new nurse practitioners trained at for-profit programs

Nearly one-third of newly licensed nurse practitioners in four U.S. states completed their education at for-profit institutions in 2024, according to research published in Annals of Internal Medicine. This figure represents a dramatic increase from just 2.4% in 2010, highlighting the expanding role these schools play in training the nation’s growing advanced practice workforce.

State-by-state distribution data

The analysis covered 117,156 nurse practitioners licensed between 2010 and 2024 in California, Florida, Iowa, and Texas. Researchers selected these large states to reflect diverse geographic regions across the country. While all four jurisdictions experienced growth in the proportion of graduates from for-profit programs, California recorded the highest share among new licensees at 40.9%. Florida followed with 35.1%, while Texas accounted for 21.1% and Iowa for 14.8%.

Workforce expansion trends

Projections from the U.S. Bureau of Labor Statistics indicate that the number of advanced nurse practitioners will rise by 35% over the next decade. This growth rate significantly exceeds that of physicians, whose numbers are expected to increase by only 3% during the same period. Concurrently, the volume of for-profit nurse-practitioner training programs surged by 400% between 2007 and 2016 alone.

Quality concerns and transparency

Dr. Michael Barnett, a professor of health services, policy and practice at the Brown University School of Public Health and senior author of the study, noted the scale of this shift. "That is enormous growth, especially since nurse practitioners are such a big workforce to begin with," Barnett said. He described the situation as an explosion in the workforce that draws more schools into providing training, with for-profit entities being newer entrants that have a checkered past in the United States.

The authors express concern regarding the quality of care associated with for-profit education. Prior evidence suggests that for-profit nursing education correlates with lower pass rates on National Council Licensure Examinations. "For-profit nursing programs have drawn regulatory scrutiny, FTC settlements and many lawsuits in the past," Barnett stated. He emphasized that hard data remains insufficient to fully assess the impact of these programs due to limited transparency.

Recommendations for future oversight

Barnett advocates for mandatory disclosure of licensure exam pass rates and other student statistics from all nurse training programs to allow public evaluation of their merits. Additionally, he recommends that researchers examine patient outcomes based on the training backgrounds of nurse practitioners to determine if significant differences in care quality exist.

The study received funding from grants provided by Arnold Ventures and the National Institute on Aging (R01AG076580). The full citation is Neprash, H. T., et al. (2026). Growth in the Share of Advanced Practice Registered Nurses Educated at For-Profit Programs in Four U.S. States. Annals of Internal Medicine. DOI: 10.7326/ANNALS-26-01211.