Empowering APP Development and Workforce Retention in Health Care

Advanced practice providers (APPs) enter the health care workforce having already completed rigorous and comprehensive training. Yet even with substantial education, most providers still require additional on-the-job training to meet the demands of clinical practice, especially as the demand for APPs across diverse clinical specialties continues to rise.

To meet these demands — and help APPs advance their individual careers — health systems are expanding support structures to promote the professional growth, competency, and long‑term retention of APPs. This support increasingly is taking the form of additional specialty‑specific education and training beyond foundational academic courses.

In the United States, non‑physician APPs now represent nearly two out of every five health care providers (40.6%), according to recent studies. And with more than 3,500 nurse practitioners and physician assistants, the UPMC health system is among the nation’s largest employers of APPs.

To keep pace with this expanding workforce, health care leaders are investing in educational resources and advanced professional development opportunities. Over the past decade, UPMC’s clinical leadership has prioritized APP development by dedicating significant resources to online learning solutions and system‑wide training initiatives, ensuring consistent, accessible, and evidence‑based education across its multi‑state system.

Bridging the Gap

More than 10 years ago, UPMC was seeking to create an educational platform that builds upon the knowledge and training APPs receive in higher education programs with hands-on preparation needed for the workforce.

Ben Reynolds, PA-C, who is a Chief Advanced Practice Officer and a physician assistant practicing trauma surgery at UPMC, had been searching for a solution to bridge this gap in a way that was accessible for all UPMC practices. He found a promising opportunity in ThriveAP.

“Realizing what was possible with this kind of solution was a true lightbulb moment for me. There was an immediate, out-of-the-box answer to a challenge we had already devoted significant time and resources to,” he explained. “I saw that we could leverage this approach even further to deliver high‑quality transition‑to‑practice programming to anyone in the UPMC workforce who needs it.”

A pilot program was implemented in UPMC’s primary care settings, showcasing measurable success between two groups of advanced practice providers — one trained through traditional methods and one supported by ThriveAP.

APPs in the ThriveAP cohort experienced zero turnover in their first year of practice, compared to 60% turnover among the non‑ThriveAP group. In addition, the ThriveAP group achieved 90% higher coding accuracy and exceeded productivity expectations, performing 25% above benchmark encounter volumes in year one and 50% above benchmark in year two — highlighting both early and sustained gains in performance.

After the completion of the pilot program, Reynolds led the implementation of ThriveAP to all primary care sites within UPMC. With the support of executive leadership, a contract was put in place to allow APPs to further their education wherever it is needed most — from oncology and pediatrics to primary care and emergency medicine.

In 2024, following five years of success at UPMC, Reynolds worked with the UPMC Enterprises team to showcase these outcomes and champion the product for a strategic investment. This investment is aligned with Enterprises’ mission to advance health care solutions and workforce development for the betterment of clinicians, health systems, and patients.

Recruiting, Retaining, and Supporting APPs

Large health systems continue to face challenges in recruiting, retaining, and supporting high‑quality advanced practice providers.

Recruiting an APP requires a significant investment because those who are high performers can be as productive as physicians yet can require substantial onboarding and development to reach that level. And if an APP leaves a practice once reaching this level, the organization loses both an employee and the investment in their professional development.

Since nearly every health system prefers candidates with previous experience, it is increasingly difficult for new graduates or APPs transitioning into new specialties to bridge the gap on their own. If a provider specializing in cardiology chooses to move to pediatrics to further their career, they may be at a disadvantage that takes time to recover.

This is where ThriveAP is delivering outcomes for APPs across the UPMC system.By providing structured education, mentorship, and specialty‑focused training, ThriveAP accelerates clinical readiness — offering a one-year program that equips students with competence that traditionally takes two years of independent practice to achieve.

“What we’ve seen with ThriveAP at UPMC is a meaningful acceleration of readiness and confidence among our advanced practice providers,” said Adele Towers, MD, MPH, FACP, CRC, director of risk adjustment at UPMC Enterprises and professor of medicine in the Division of Geriatric Medicine at the University of Pittsburgh. “When providers feel prepared and supported early on, it shows in both patient care and long‑term workforce stability.”

For seasoned APPs shifting into new clinical areas, ThriveAP helps “fill in the blanks” by shortening the steep learning curve and ensuring safe, successful transitions.

“Real-world practices at the bedside and in clinics change so rapidly, that it can be difficult for academic programs to keep up,” Reynolds said. “Even for those of us who have been practicing for many years can struggle with some of the state-of-the-art changes we see every year.”

Empowering APPs Through Technology

Health systems face many workforce challenges, as they adapt to new ways to attract, develop, and retain well-educated and high-quality staff across a wide range of specialties. Research has shown that technology provides a solution to overcome such hurdles.

A recent report from Center for Connected Medicine at UPMC and KLAS Research shows just how essential digital tools have become. With 80% of health system leaders reporting that technology is vital to addressing workforce challenges and 90% planning additional investments, health systems are leaning on innovation to strengthen every stage of the employee journey, from recruitment and onboarding to long‑term retention and workforce optimization.

As organizations confront workforce shortages that threaten access, quality, and sustainability, technology is helping teams do more with limited resources. Clinicians and patients in locations with less access depend heavily on virtual or adaptable resources.

ThriveAP expands education for APPs and facilitates better patient outcomes through the rigor of its online learning platform, thereby helping close long‑standing gaps in both rural and urban communities.

This model is especially transformative for rural health systems, where APPs can face geographic isolation, limited training resources, and fewer opportunities for specialty mentorship. Virtual programs bring state‑of‑the‑art education directly to these providers, supporting their transition into practice and strengthening care delivery in communities that need it most.

“Even in a resource-constrained environment, you still need to be making the best possible investments in your workforce to be successful,” Reynolds said. “Health systems are going to be thinking about how they can foster a good workforce, and these sort of adaptable and high-quality platforms are essential to that success.”

A Benefit for Patients and Providers

By equipping APPs with the skills and support they need to succeed, UPMC’s experience with ThriveAP shows that the solution can enhance provider retention and development and help patients benefit from timely, expert, and consistent care, no matter where they live.

“We want to support all of our APPs equally and be able to provide them with the tools to be successful when they come into our practices,” Reynolds said.

Next Steps

• Download “Transforming Health Care Workforce Management: How Technology Can Address Workforce Challenges at Health Systems” for more insights.
• Learn more about ThriveAP.

Note: UPMC has a financial interest in ThriveAP.