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.
Available from: Gail A Jensen
- "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. "
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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.
Available from: ncmedicaljournal.com
- "ElectronicallyConcerns about a national shortage of primary care physicians have been raised in both the academic literature11121314and in the popular press[15,16]. Between 1991 and 2010, however, North Carolina's primary care physician workforce grew at a rate of 42%, compared with a growth rate of only 35% for the state's physician workforce as a whole. "
Available from: Patricia B Reagan
- "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. "
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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.
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