Although the national APP turnover rate is in decline...
Organizations must continue to address it.
Reducing APP turnover is not just a staffing issue – it’s a strategic imperative for delivering sustainable, high-quality health care.
What’s actually influencing retention in today’s competitive clinical talent landscape? Contrary to common assumptions, compensation isn’t the primary driver. Utilization is.
When APPs aren’t empowered to work at the top of their license, organizations risk disengagement, inefficiency, and ultimately, turnover.
In our new video, Hadley Powless explains how SullivanCotter can help to promote stability, continuity and efficiency across your entire care team.
APP turnover is a costly reality.
Need additional insight? Our new analysis uncovers several powerful predictors of retention.
For organizations seeking to strengthen retention in 2026 and reduce the cost of APP turnover, understanding these drivers is essential.
Video Transcript
I’m Hadley Powless and I am a Consulting Manager at SullivanCotter. I am also a practicing advanced practice provider. Specifically, I am a PA with over 18 years of experience working in both clinical and APP leadership roles.
Over the past three years, we’ve seen a slight but meaningful decline in external turnover among APPs. In 2023, the national turnover rate was 12%. In 2024, it dropped to 11%, and according to SullivanCotter’s most recent APP Compensation and Productivity Survey, we’re now seeing the lowest rate since 2022—just 10%.
But what’s driving turnover when it does happen? Using over five years of data from our APP Preferences Survey, we’ve identified the top reasons APPs consider leaving their organizations. Surprisingly, compensation is not the leading factor. The number one reason APPs report is minimal or no utilization in their role—they’re simply not being used to their full potential and working at the top of their license. The second most common reason is working with physicians or staff who don’t fully understand the APP role or capabilities. Third is an ineffective orientation program, and fourth is the perception of lower compensation compared to peers at other organizations.
So why should you care about APP turnover? Because it’s costly—financially and operationally. High turnover leads to increased recruitment and training expenses, lost productivity, and disruptions in patient care. It strains remaining staff and can negatively impact outcomes and satisfaction. When APPs leave, organizations often face coverage gaps and a loss of valuable institutional knowledge. Addressing turnover is not just a staffing issue—it’s a strategic imperative for sustainable, high-quality care delivery.
Low turnover, on the other hand, is the ideal. It promotes stability, continuity, and efficiency across care teams. At SullivanCotter, we help organizations achieve this by evaluating care team models and identifying opportunities for improvement. When we work with clients in care team optimization, we spend valuable time together, collaborating on a few essential steps. First, we assess current roles and responsibilities, analyze patient-provider workflows, and sometimes, conduct quantitative assessments. Next, we work together to define a future-state care model—one that enhances access, engagement, quality, and cost-effectiveness for all. As a last step, we partner together to create an implementation plan with a focus on long-term success.
If you’re interested in learning more or have questions about APP turnover and care team optimization, feel free to reach out—we’re always happy to share insights and continue the conversation.