Sunday, May 25, 2014

The Provider Shortage Problem: The Definitive Bottom 5 States

So far this month our theme has been provider shortage problems, an issue that plagues every State to one extent or another according to the latest data from the Health Resources and Services Administration (HRSA).  Today we will divulge the Definitive Bottom 5 States, the ones with the overall worst provider shortage problems, based on our analysis of May 2014 data from the HRSA.

To this point we have presented our lists of the 5 States with the worst shortages in three separate areas: primary care, dentists and mental health care.  In our analysis of the HRSA data, the key consideration is the size of the provider shortage in a State relative to its overall population.  The absolute number of providers needed to eliminate a shortage in a particular State does not paint the whole picture.  If two States have the same provider shortage in absolute terms, one might conclude that their provider shortage problem is the same.  Yet if one State has triple the overall population of the second State, it becomes apparent that the smaller State has a more severe problem.  So in our analysis, it is the relative provider shortage that counts the most.

Our assessment of the Definite Bottom 5 States follows the same methodology we used when developing our prior lists.  We looked at the aggregate shortage of primary care physicians, dentists and psychiatrists in each State in relation to the aggregate national shortage of these providers.  We then compared those results against each State's share of the national population.  Our Definitive Bottom 5 States had an overall provider shortage (primary care physicians, dentists and psychiatrists) that was disproportionately out of whack given each State's total population.

So without further adieu, the worst-of-the-worst provider shortage problems, our Definitive Bottom 5 States:

Fifth worst place belongs to Alabama.  Based on May 2014 HRSA data, the State is short 545 providers, which is 3% of the national total of just under 18,000.  Alabama only accounts for 1.5% of the national population, so its shortage is about double what one would expect given its population size.  Alabama is particularly short of dentists, which make up over 55% of its provider shortfall.

Coming in fourth from the bottom is Missouri.  The State, which accounts for about 1.9% of the nation's population, is short 738 providers, or about 4.1% of the national total. Primary care physicians is where Missouri's provider shortage is most severe.

Sitting at third worst in our Definitive Bottom 5 is Arizona, with a shortage of 1,050 providers, or about 5.8% of the national total.  Home to approximately 2.1% of the population, the State's shortage is about 2.7X times more than one would expect given its population.  Arizona is weak across the board, making our "5 Worst" lists for primary care physicians, dentists and psychiatrists.

In the number 2 spot on our Definite Bottom 5 list is New Mexico.  The State is home to 1.9% (347 providers) of the national provider shortage, but its share of the national population is less than 0.7%.  Consequently, its provider shortage is more out of balance with its population than all other States, except one.  Like Arizona, New Mexico has provider shortage problems across the board and also made each of our prior "5 Worst" lists.

And who takes the bottom spot on our list of the Definite Bottom 5 States for Provider Shortage Problems?  That dishonor goes to Mississippi.  The State has an aggregate provider shortage of 495 professionals, or about 2.75% of the national total.  As compared to its population, which is approximately 0.94% of the national total, Mississippi's provider shortage is 2.93X worse than one would expect for its population.  That result barely edged out New Mexico's provider shortage, which was 2.92X worse than expected given the size of its population.

So there you have it.  The Definitive Bottom 5 States for Provider Shortage Problems.  Let's hope the political leaders in each of these States drums up the courage to implement corrective policies that would encourage more primary care physicians, dentists and psychiatrists to set up shop in their respective states.  Sadly, that is probably asking too much.