Sunday, May 11, 2014

5 States with the Worst Primary Care Shortage

Before taking a look at the 5 States with the Worst Primary Care Shortage, let's examine the national scene.  The Health Resources and Services Administration (HRSA) designates more than 6,000 geographic areas, population groups or facilities across the country has having a primary care shortage.  More than 60 million people, or about 19% of the U.S. population, live in a designated primary care shortage area.

Shortage areas exist in every State of the Union and what these areas share in common is that each has fewer than 1 primary care physician for every 3,500 people who live in the area. Using this metric, the HRSA's May, 2014 data estimates that close to another 8,100 primary care physicians are needed to provide adequate care to residents of these shortage areas.  Some healthcare experts think the actual shortage is more like 16,000, arguing that the formula of 1 primary care physician for every 3,500 people used by the HRSA is understated.

While some experts assess the situation differently, all agree that a sizable portion of the nation lacks adequate access to primary care physicians.  Moreover, everyone agrees that the shortage of primary care physicians will grow worse over the next 5 to 10 years at least.  The fundamental problem is basic supply and demand.  On the one hand, demand is growing due to several factors:  (1) the population as a whole continues to grow; (2) the population over 50, which naturally require more primary care services, is growing at an even faster rate than the overall population; and (3) under Obamacare millions more have, or will have, health insurance coverage than under our "historical" system, thereby making primary care more financially accessible than ever.  On the other hand, U.S Medical Schools are definitely turning out new primary care physicians every year, so the supply of primary physicians is growing.  However, the pace of supply growth has not been, nor is it expected to be, fast enough to keep pace with demand growth.  So with demand growing at a faster clip than supply, the experts agree that today's primary care shortfall, whether it is 8,000 or 16,000, is only going to get worse in coming years.

So which 5 States have the worst primary care shortage?  If we looked at the raw numbers alone, the 5  largest population states would make our list.  But in our analysis, raw numbers alone do not provide an accurate picture.  What matters in our analysis is a State's primary care shortage in relation to the size of its population.  To be a candidate for our "5 States with the Worst Primary Care Shortage" list, a State has to have a shortage that is disproportionately large for the State's total population.

So who are the 5 States with the Worst Primary Care Shortage?

At number 5 is North Dakota.  According to HRSA's May, 2014 data, the North Dakota shortage was a mere 34 primary care physicians, or just 0.42% of the national primary care shortage.  But with only about 0.22% of the national population, North Dakota's primary care shortage is almost double what one would expect it to be given its population.  We found only 4 States that had disproportionately worse conditions.

Coming in 4th on our list is Missouri.  Its shortage of 363 primary care physicians is about 4.5% of the national total.  In comparison, its population is under 2% of the national population, so the State's shortage is over 2.3X more than one would expect to see for a State the size of Missouri.

In 3rd place is Arizona.  Its primary care shortfall is 5.1% of the national shortage, while its population is 2.1% of the national total.  Not good.

The second worst primary care shortage on our list belongs to Mississippi. The state has a shortage of 230 primary care physicians, or about 2.85% of the national total based on HRSA data.  That is more than triple what one would expect given that the state has just 0.94% of the national population.

And occupying last place on our list of the 5 States with the Worst Primary Care shortage is New Mexico.  The state's 163 primary care physician shortage is 2.02% of the national shortfall total, while its population is 0.66% of the national population.  While Mississippi came in a close second, no other state has a primary care shortage more out of proportion with its state population than does New Mexico.