Some people follow their job, moving wherever their position takes them. Others know exactly where they want to live and then find a job that fits their needs. If you’re a nurse practitioner, it doesn’t matter which of these camps you fall into. The latest employment data shows that not only are your skills in high demand across the country, but also that employers are willing to pay very good money to have you work for them. Now, the only question you need to answer is: do you stay where you are, or do you move someplace else?
To help you figure this out, we collected data and rankings for each state along 5 metrics that play a key role in an NP's professional and personal lives:
- Cost of Living
- Job Demand/Growth
- Quality of Life
- Scope of Practice
Together, all these pieces of information can help give you a better idea of what states would be most ideal for you to live and work, based on your priorities and preferences.
Below, we've provided you with a high-level summary of the best and worst states for NPs in 2021 across those 5 key metrics. If you want to dig deeper into the data, we've also provided detailed explanations of how each metric was calculated, along with state-by-state rankings for all 50 states.
SUMMARY: The Best & Worst States for Nurse Practitioners in 2021
For your skimming pleasure, here's a high-level summary of the best and worst states for NPs in 2021 across the 5 key metrics.
The Best & Worst States for Nurse Practitioners: Salaries
|The 5 Highest-Paying States for Nurse Practitioners|
|1. California: $138,660/year|
|2. Washington: $126,920/year|
|3. Hawaii: $124,000/year|
|4. New Jersey: $123,810/year|
|5. Minnesota: $122,850/year|
|The 5 Lowest-Paying States for Nurse Practitioners|
|46. South Carolina: $100,680|
|47. Kansas: $100,550|
|48. Alabama: $99,570|
|49. Kentucky: $99,560|
|50. Tennessee: $96,510|
Source: Bureau of Labor Statistics (BLS) - "Occupational Employment and
Wages Data for Nurse Practitioners - May 2019" (Last accessed March 2021)
The Best & Worst States for Nurse Practitioners: Cost of Living
|The 5 Most Affordable States for Nurse Practitioners|
|The 5 Least Affordable States for Nurse Practitioners|
Source: U.S. News & World Report - "Best States of 2021 - Affordability Rankings" (Last accessed March 2021)
The Best & Worst States for Nurse Practitioners: Job Growth
|The 5 States With the Highest Projected Demand for Nurse Practitioners|
|1. New York|
|The 5 States With the Lowest Projected Demand for Nurse Practitioners|
Source: ProjectionsCentral.com - "Long-Term Occupational Projections: 2018-2028" (Last accessed March 2021)
The Best & Worst States for Nurse Practitioners: Quality of Life
|The 5 Best States for Nurse Practitioners' Quality of Life|
|4. New Hampshire|
|The 5 Worst States for Nurse Practitioners' Quality of Life|
|47. West Virginia|
|48. New Mexico|
Source: U.S. News & World Report - "Best States of 2021 Rankings" (Last accessed March 2021)
The Best & Worst States for Nurse Practitioners: Scope of Practice
|The Best States for Nurse Practitioners: Full Practice Authority|
|District of Columbia||Hawaii|
|New Mexico||North Dakota|
|The Worst States for Nurse Practitioners: Restricted Practice Authority States|
Source: American Association of Nurse Practitioners (AANP) - "State Practice Environment" (Last accessed March 2021)
Nurse Practitioner Salaries: By State
It goes without saying that money is a great motivator, particularly when it comes to making career-related decisions. That said, salaries tend to vary (and sometimes significantly) from state to state. To show you what your earning potential could be in each state, we've shared the latest BLS salary data for NPs below. (Keep in mind that all BLS data reflects the employment and wage numbers for NPs as of May 2019, which the BLS published in May 2020.)
Nurse Practitioner Salaries: State by State
|Rank||State||Average Annual Salary for Nurse Practitioners||Average Hourly Pay for Nurse Practitioners|
Cost of Living for Nurse Practitioners: By State
Of course, no conversation around salary can be complete without also taking into account the cost of living for a given area. While having raw salary data can be helpful to give you a general idea of your earning potential, you'll get a much more realistic picture of your actual income when you understand just how much of it will be going toward living and housing expenses. For example, if you have a high-paying job in a state that tends to have a very high cost of living, then you would expect to see most (if not all) of your paycheck going toward your living expenses. But, if you had an average salary in a state with a low cost of living, you’d be more likely to have some money left over to spend however you wanted.
To help you get a better picture of your earning potential in different states, we turned to U.S. News's 2021 Affordability Rankings, which was part of their larger Overall Best States of 2021 ranking (more on this later). To determine how affordable each state was, U.S. News gave them scores on 2 metrics: cost of living and housing affordability. Based on those scores, each state then received an overall ranking on a scale of 1 to 50, with 1 being the most affordable and 50 being the least affordable.
Below, you'll find U.S. News's Affordability rankings for all 50 states, along with their respective scores across the 2 metrics.
2021 Cost of Living Rankings: State by State
|Overall Rank||State||Cost of Living Score||Housing Affordability Score|
Demand/Job Growth for Nurse Practitioners: By State
The more job openings there are, the greater the need there is for a specific profession. This is particularly true for NPs, who should expect to see the number of available jobs increase by about 52% between 2019 and 2029. (This should translate to about 110,700 new jobs opening up during that time.)
The only problem is that this significant job growth won’t be spread equally across the U.S. Naturally, some states will see higher rates of job growth than others. Below, we’ve shared occupational projection numbers from Projections Central to show you how much demand there will be for NPs on a state-by-state basis between now and 2028, both in terms of raw job opening numbers and job growth percentage.
You’ll notice that there are some two-way ties in the number of job openings. Within those tied pairs, we ranked them based on who had the higher job growth percentage.
Projected Job Demand for Nurse Practitioners, 2018-2028: State by State
|Overall Rank||State||Average Annual Job Openings for Nurse Practitioners||Job Growth Percentage (2018-2028)|
|50||Louisiana||No Data Available||No Data Available|
Quality of Life for Nurse Practitioners: By State
Once we got a better understanding of what each state could offer NPs as far as earning potential, job growth, and cost of living, we decided to find out the kind of quality of life NPs could expect to have in each area. To do this, we turned to U.S. News’ 2021 Best States Rankings, which considered a whole host of natural and social environment factors on a state-by-state basis. They determined each state's rank by first scoring them along the following 8 metrics:
- Fiscal Stability
- Crime & Corrections
- Natural Environment
The scores were on a scale of 1 to 50, with 1 being the best and 50 best the worst. They then used those scores to provide an overall ranking for each state. (You can read more about their methodology here.) Below, we've provided you with quality of life rankings for all 50 states, along with their scores for each of the 8 individual metrics.
2021 Quality of Life Rankings: State by State
|Overall Rank||State||Healthcare Score||Education Score||Economy Score||Infrastructure Score||Opportunity Score||Fiscal Stability Score||Crime & Corrections Score||Natural Environment Score|
Nurse Practitioner Scope of Practice: By State
Practice authority is the amount of restriction and oversight an NP needs to practice in any given state — and each state’s laws and regulations will differ. The American Association of Nurse Practitioners (AANP) categorizes state practice environments into three groups:
- Full Practice Authority: According to the AANP, “State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.” These are the best states for NPs looking to open their own practice.
- Reduced Practice Authority: “State practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.”
- Restricted Practice Authority: “State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care.”
Currently, most U.S. states give NPs full practice authority, but there are still a considerable number that don’t. Here’s how it breaks down:
The Best & Worst States for Nurse Practitioners' Scope of Practice
|Full Practice Authority States|
|District of Columbia||Hawaii|
|New Mexico||North Dakota|
|Reduced Practice Authority States|
|Restricted Practice Authority States|
Originally published on August 23, 2019.
Updated on March 1, 2021.