Seven Million Americans Live In Areas Where Demand For Primary Care May Exceed Supply By More Than 10 Percent

Pritzker School of Medicine, University of Chicago, in Illinois.
Health Affairs (Impact Factor: 4.97). 02/2013; 32(3). DOI: 10.1377/hlthaff.2012.0913


The Affordable Care Act’s expansion of insurance coverage is expected to increase demand for primary care services. We estimate that the national increase in demand for such services will require 7,200 additional primary care providers, or 2.5 percent of the current supply. On average, that increased demand is unlikely to prove disruptive. But when we examined how this increased demand will be experienced in different areas of the country, we found considerable variability: Seven million people live in areas where the expected increase in demand for providers is greater than 10 percent of baseline supply, and forty-four million people live in areas with an expected increase in demand above 5 percent of baseline supply. These findings highlight the need to promote policies that encourage more primary care providers and community health centers to practice in areas with the greatest expected need for services.

8 Reads
  • Source
    • "On the other hand, the combined effects of these provisions are somewhat ambiguous. One reason is that if primary care physicians are already working near capacity, as some observers maintain (Mitka 2007; Hofer et al. 2011; Huang and Finegold 2013), then there simply may not be enough capacity for both effects to occur. Another is that while Medicaid Parity is sure to raise the expected profitability Medicaid patients, it is unclear how their profitability compares to the expected profitability of Medicare patients. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Using 2008 physician survey data, we estimate the relationship between the generosity of fees paid to primary care physicians under Medicaid and Medicare and his/her willingness to accept new patients covered by Medicaid, Medicare, or both programs (i.e., dually enrolled patients). Findings reveal physicians are highly responsive to fee generosity under both programs. Also, their willingness to accept patients under either program is affected by the generosity of fees under the other program, i.e., there are significant spillover effects between Medicare and Medicare fee generosity. We also simulate how physicians in 2008 would have likely responded to Medicaid and Medicare payment reforms similar to those embodied in the 2010 Affordable Care Act, had they been permanently in place in 2008. Our findings suggest that "Medicaid Parity" for primary care physicians would have likely dramatically improved physician willingness to accept new Medicaid patients while only slightly reducing their willingness to accept new Medicare patients. Also, many more primary care physicians would have been willing to treat dually enrolled patients.
    International Journal of Health Care Finance and Economics 07/2014; 14(4). DOI:10.1007/s10754-014-9152-y · 0.49 Impact Factor
  • Source
    • "In addition, high uninsurance and poverty rates can reduce patient demand as these potential patients are more likely to go without care because of financial constraints (Burman, Mawhorter, & Vanden Heede, 2006). Indeed it is precisely these areas that are predicted to require the greatest increase in primary care providers to meet the new demand brought about by the ACA (Huang & Finegold, 2013). High percentages of people older than 65 are thought to increase demand because of their high use rates and access to Medicare. "
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: It is widely recognized that there is significant state-level variation in scope-of-practice regulations (SSoPRs) for nurse practitioners (NPs). PURPOSE: This study was designed to examine whether SSoPRs influence labor markets for NPs. METHOD: Cross-sectional analysis examining how SSoPRs influence the number and growth in NPs; data from the Area Resource File and 2008 Pearson report were used. DISCUSSION: Restrictive SSoPRs reduced the number of NPs by about 10 per 100,000 and reduced the growth rate by 25%. No difference was found between states with the most restriction and those with some restrictions. CONCLUSIONS: These results imply that changes to practice regulations should not be incremental but should follow the current practices in the least restrictive states. Results also indicate that other factors (poverty, uninsurance rates, rurality) decreased the number of NPs, suggesting that solving the primary care provider shortage will require multiple strategies.
    Nursing outlook 05/2013; 61(6). DOI:10.1016/j.outlook.2013.04.007 · 1.59 Impact Factor
  • Source
    • "Between 2001 and 2010, there was a 13.6% increase in all residents but a 6.3% decrease in the number expected to enter primary care [10]. Huang and Finegold [11] recently estimated that 48 million Americans live in areas in which the projected need for primary care physicians is more than 5% above the currently available supply, a shortage that will be aggravated by plans to expand health insurance to over 12 million previously uninsured by the Patient Protection and Affordable Care Act (PPACA) [12]. The shortfall and related limits on access to primary care as compared to other nations [13] have been related to the United State’s low population health rankings [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The choice of a specialty by medical students is a complex one that has significant implications for the future supply of physician manpower. The study by Weissman et al. portrays this choice as reflecting the degree of congruence between a student's needs and values and his or her perception of the characteristics of the various specialties. The existing shortages in the supply of various specialists in Israel may be interpreted as signifying a lack of alignment of student needs and perceptions. . This commentary will extend the implications of this work to include the connection between students' choices and the physician manpower needs of society, and will focus on primary care physician shortages in the United States as but one example of the implications of these relationships.
    Israel Journal of Health Policy Research 05/2013; 2(1):18. DOI:10.1186/2045-4015-2-18
Show more