The number of clinicians specializing in nursing home care increased by 33.7% from 2012 to 2015, although nursing home specialists made up only 21% of nursing home clinicians in 2015. Most of these specialists were advanced practitioners (physician assistants and nurse practitioners) delivering post-acute care. The change in number of nursing home specialists varied significantly by geographic region.
The Affordable Care Act required that consumers have access to in-person or on-call assistance to understand their choices and "navigate" the complexities of the new health insurance marketplaces. One consequence of each state's decision about whether to run its own marketplace is an extreme variation in the time-limited funding available for consumer assistance programs.