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Ny State (NYS) has around 4.7 million Medicaid beneficiaries with 75% having at least one or higher persistent problems. An estimated 10percent of Medicaid beneficiaries seek emergency department (ED) solutions for nonurgent matters. It really is uncertain if a heightened way to obtain nursing assistant practitioners (NPs) and physician assistants (PAs) influence utilization of ED and subsequent hospitalizations for chronic problems. A cross-sectional study design