Ten States Most Under-Served by Registered Nurses

According to Area Health Resource Files (AHRF) data available from the Health Resources and Services Administration, there are 839 registered nurses employed for every 100,000 people here in the United States .  Among all health professions, that is the largest number of practitioners per 100,000 population in the U.S., which is not really surprising given the essential role registered nurses (RNs) play in quality healthcare delivery.  What may be more surprising is how much disparity exists in registered nurse employment from State to State.  As this map of registered nurse employment per 100,000 population reveals, some areas of the country are much better served by RNs than are others:

There are 31 States in all that have registered nurse employment that exceeds the 839 per 100,000 population national average.  And within this group there are a dozen States, mainly in the Northeast and Great Plains regions, that are particularly well served by registered nurses with employment greater than 1,000 registered nurses per 100,000 population.  But while some States are well served by RNs, there are 19 States, predominantly in the South and West, where registered nurse employment lags behind the national average. Some of these laggards, like California and Texas, actually have RN employment numbers among the highest in the nation in absolute terms.  But even in these two big States, RN employment is proportionately weak given their size.  With 719 RNs employed per 100,000 population, only 9 States are more under-served by registered nurses than Texas.  And the situation in California is poorer still, where just 657 RNs employed per 100,000 population makes the State more under-served by registered nurses than all but three States.  The State most under-served by registered nurses is Nevada, which has just 609 RNs employed per 100,000 people.  Unfortunately, for Nevada and other States that lag behind the national average, the situation could easily get worse in coming years.  The job outlook for RNs indicates a growing need for registered nurses due to a variety of demographic and technological factors.  This trend will will only exert more pressure on States already struggling to attract RNs.  Besides Nevada, California and Texas, here are the Ten States Most Under-Served by Registered Nurses based on current HRSA data:

The Top Ten States for Medicare Advantage Enrollment

A few words about Medicare Advantage (MA) Plans before identifying the Top Ten States for Medicare Advantage Enrollment.  MA plans are an increasingly popular type of health plan offered by private companies as an alternative to original Medicare.  These private companies contract with the federal government to provide Medicare Part A and Part B benefits coverage to Medicare beneficiaries in select regions of the country.  With a MA Plan, the government basically pays a stated amount to a private company to provide an enrollee with a health plan that, at a minimum, matches Original Medicare Part A and Part B benefits.  What gives Medicare Advantage plans their appeal is that private companies have been able to bundle Part A and Part B benefits, plus a variety of extra benefits, into their plans at little to no cost to enrollees.

With typically lower costs and additional benefits, MA Plans can be a great value compared to Original Medicare.  Alas, that added value is frequently created, in part, from the imposition of managed care protocols and restricted provider networks not found with Original Medicare.  While MA Plans can come in a variety of insurance models, the most popular Medicare Advantage plan feature health maintenance organization and preferred provider organization structures.  Yet even with managed care protocols and fewer provider choices, lots of Medicare eligible seniors like the value MA plans offer.  There are currently about 15.3 million Americans enrolled in Medicare Advantage plans, an increase of close to 50% over the past 5 years.  MA plan enrollees now account for 30% of the total Medicare population, up from a 23% share five years ago.

To no surprise, the largest population States contribute the biggest share of Medicare Advantage plan enrollees nationwide.  But only four of those big population States ranked as a Top Ten State for Medicare Advantage enrollment in our estimation.  Those honors belong to the ten States where the MA percentage share of the total Medicare population is greatest.  Of the seventeen States where the Medicare Advantage share of the total Medicare population exceeds the 30% national average, here are the Top Ten States for Medicare Advantage Enrollment:

Source:  Kaiser Family Foundation