How to Pay & Retain a PA/NP in 2026

Rethinking PA/NP Compensation in 2026: Inflation, ROI, and Retention

As we head into 2026, private practices are facing a new reality in workforce planning. Inflation has lingered above historical norms for several years, eroding real wages and changing expectations across the healthcare labor market. For physician assistants (PAs) and nurse practitioners (NPs), demand continues to grow. Compensation hasn’t always kept pace with their value to practices. To recruit, retain, and empower top talent in this environment, practices must rethink how they structure compensation - both for new hires and for current providers.

Why Inflation Demands a Compensation Reset

Inflation has steadily increased the cost of living and operating a practice, affecting everything from rent to staffing costs. In many sectors outside healthcare, employers have responded with salary adjustments that outpace traditional merit increases. Healthcare, however, has lagged. Wage growth is often instead tied to reimbursement rates rather than real market conditions.

For PAs and NPs, this means that even when nominal salaries rise, real purchasing power can decline unless compensation grows at or above inflation. Practices that ignore this trend risk losing providers to competitors who do adjust pay meaningfully.

Current PA/NP Salary Landscape (2026 Data)

Understanding where compensation currently sits is an important baseline for planning:

• National average salary for a PA/NP in 2026 is approximately $126,700 per year, with a typical range from about $116,000 to $142,000 depending on experience and location. (Salary.com)

• Specialty-level data suggests experienced PAs can earn well into the $160,000+ range, especially in high-revenue areas like surgical specialties or emergency medicine. (The Physician Assistant Life)

• NPs also command competitive pay, particularly in specialties or states with expanded practice authority; some surveys find average NP compensation north of $133,000–$138,000 annually in 2025–26. (Dermatology Times)

• Compensation growth is trending upward overall, with surveys indicating year-over-year increases — though still modest in some sectors. (apea.com)

  
  

These figures reflect base salaries and do not always include productivity bonuses, benefits, or incentives — all of which can materially alter total compensation packages.

The Value Providers Bring: ROI Beyond Salaries

PAs and NPs are revenue drivers for most practices. They generate billable patient care, increase capacity, improve access, and often help grow referral streams. Some key points:

• Top-performing NPs can generate over $1.4 million in submitted billing annually, demonstrating the significant financial contribution these providers make.

• In many practice models, a productive PA or NP can generate 2–4x their cost in collections when overhead and benefits are factored in — an ROI few other investments can match.

  
  

Even when overhead and benefits are included, paying providers at market-competitive levels typically leads to positive return on investment — especially when compared with the cost of provider vacancies, locum tenens coverage, or provider turnover.

What Should Compensation Look Like in 2026?

Given inflation and competitive pressures:

1. Raise baseline offers: Practices should be targeting $135,000–$150,000+ for experienced PA/NP new hires, with geographic adjustment for high-COL areas.

2. Compensate current providers fairly: It’s not enough to set higher offers for newcomers — current team members should see raises that bring their pay in line with market trends and cost-of-living realities. Doing so:

   • Reinforces loyalty and respect.

   • Reduces turnover risk.

   • Builds a culture where providers feel valued.

3. Incorporate productivity/incentive design: Pay structures that reward patient volume, RVU production, or practice growth tie compensation directly to ROI and create alignment between individual performance and organizational success.

   
   

Internal Alignment Before Expansion

Too often, practices hire at higher market rates without first updating internal compensation structures. This creates tiering — where newer hires outpace veteran team members in pay — and can erode morale. A better strategy:

• Benchmark all provider compensation annually using up-to-date salary surveys.

• Adjust current employee pay before extending new, higher offers.

• Communicate transparently about the rationale and process for pay changes.

  
  

This approach cultivates a culture rooted in trust, fairness, and respect — essential factors in retention and long-term staff engagement.

Pay for Value, Not Tradition

In 2026, inflation and workforce competition demand a compensation philosophy grounded in value creation and equity. Practices that:

✅ Pay market-competitive salaries

✅ Adjust existing team members first

✅ Use incentive structures linked to productivity will not only attract top PA/NP talent — they’ll retain it.

If you're needing to hire a PA or NP in 2026 OR you're a PA or NP working for a practice that will not increase your pay to match the market - reach out to me!

Madison Traylor, CEO of Advanced Scope Recruitment

Madison@advancedscopetalent.com

C: 864-432-0670