The Rocky Mountain Region's Top Teaching Hospital

This is the last of a series of blog posts over the past few weeks devoted to top teaching hospitals by region.  We have identified the top 5 teaching hospitals in each region from the 137 hospitals in the U.S. that earned national distinction in at least one of the 16 adult specialties studied  in the most recent U.S. News & World Report rankings of American hospitals. As the least populated region of the country, the Rocky Mountain region poses a problem for our top 5 teaching hospitals by region series.  The Council of Teaching Hospitals and Health Systems, which is part of the Association of American Medical Colleges, lists only three teaching hospital members in the region..  And of those Rocky Mountain teaching hospitals, only one earned national recognition in at least one of the adult specialties covered in the U.S. News survey:

Top Teaching Hospitals

University of Colorado Hospital
Location:  Denver
Beds: 467
Nationally Ranked Adult Specialties:  11 of 16
Top 10 Rankings: #2 in Pulmonology

Other Top 20 Rankings:#12 in Nephrology, #15 in Cancer
Top 15 Overall Ranking Nationally:  No


To find other teaching hospitals in the Rocky Mountain region and elsewhere, visit our U.S. Teaching Hospitals resource page.

New England's Top 5 Teaching Hospitals

137 hospitals in the U.S. earned national distinction in at least one of the 16 adult specialties studied  in the most recent U.S. News & World Report rankings of American hospitals.  Five of the hospitals earning such recognition are teaching hospitals in New England, including Massachusetts General Hospital, which earned the top rating among all hospitals in the nation. As derived from the U.S. News rankings, here are the Top 5 Teaching Hospitals in New England.

Top 5 Teaching Hospitals

Massachusetts General Hospital
Location:  Boston
Beds:  947
Nationally Ranked Adult Specialties:  16 of 16
Top 10 Rankings: 15 specialties
#1 in Ear, Nose & Throat, #2 in Neurology & Neurosurgery, #2 in Diabetes & Endocrinology, #2 in Psychiatry, #3 in Gastroenterology & GI Surgery, #4 in Geriatrics, #4 in Ophthalmology, #4 in Gynecology, #4 in Pulmonology, #4 in Orthopedics, #5 in Cardiology & Heart Surgery, #6 in Nephrology, #6 in Rheumatology, #6 in Rehabilitation, #8 in Cancer.

Other Top 20 Rankings:  #16 in Urology.

Top 15 Overall Ranking Nationally:  Yes (1st)

Brigham and Women's Hospital
Location:  Boston
Beds: 779
Nationally Ranked Adult Specialties:  13 of 16
Top 10 Rankings: 10 specialties
#2 in Gynecology,  #4 in Cancer, #4 in Cardiology & Heart Surgery, #5 in Nephrology, #5 in Pulmonology, #5 in Rheumatology, #6 in Neurology & Neurosurgery, #7 in Orthopedics, #9 in Diabetes & Endocrinology, #9 in Geriatrics.

Other Top 20 Rankings:  #12 in Gastroenterology & GI Surgery, #14 in Urology.

Top 15 Overall Ranking Nationally:  Yes (6th)

Yale-New Haven Hospital
Location:  New Haven, CT
Beds:  1571
Nationally Ranked Adult Specialties:  8 of 16
Top 10 Rankings: #8 in Diabetes & Endocrinology, #10 in Psychiatry
Other Top 20 Rankings: None
Top 15 Overall Ranking Nationally:  No

Baystate Medical Center
Location:  Springfield, MA
Beds:  716
Nationally Ranked Adult Specialties:  2 of 16
Top 10 Rankings: None
Other Top 20 Rankings: None
Top 15 Overall Ranking Nationally:  No

Beth Israel Deaconess Medical Center
Location:  Boston
Beds: 649
Nationally Ranked Adult Specialties:  1 of 16
Top 10 Rankings: None
Other Top 20 Rankings: None
Top 15 Overall Ranking Nationally:  No

To find teaching hospitals in other regions, visit our U.S. Teaching Hospitals resource page.

The 5 Best Teaching Hospitals in the Far West

For updated information, see The Far West's Top 5 Teaching Hospitals in 2021

Extracted from the most recent U.S. News & World Report rankings of American hospitals, the 5 Best Teaching Hospitals in the Far West include 3 of the top 15 hospitals in the country.  Only 137 hospitals earned national recognition in at least one of 16 adult specialties studied in the U.S. News survey. All 5 best teaching hospitals in the Far West earned recognition in at least 12 of these specialties.

5 Best Teaching Hospitals

UCLA Medical Center
Location:  Los Angeles
Beds: 466
Nationally Ranked Adult Specialties:  15 of 16
Top 10 Rankings: 13 specialties
#2 in Geriatrics, #3 in Urology, #4 in Gastroenterology & GI Surgery, #5 in

Ophthalmology, #6 in Cancer, #7 in four specialties (Nephrology, Neurology & Neurosurgery, Psychiatry and Rheumatology), #8 in two specialties (Gynecology and Orthopedics), #9 in two specialties (Pulmonology and Ear, Nose & Throat).

Other Top 20 Rankings:  #12 in two specialties (Cardiology & Heart Surgery and Diabetes & Endocrinology).

Top 15 Overall Ranking Nationally:  Yes (tied for 3rd)

UCSF Medical Center
Location:  San Francisco
Beds: 650
Nationally Ranked Adult Specialties:  14 of 16
Top 10 Rankings: 7 specialties
#4 in three specialties (Diabetes & Endocrinology, Nephrology and Neurology & Neurosurgery), #5 in Urology, #6 in Gynecology, #9 in Cancer, #10 in Rheumatology.
Other Top 20 Rankings:  6 specialties
#11 in Ear, Nose & Throat, #12 in Psychiatry, #13 in two specialties (Orthopedics and Geriatrics), #15 in Gastroenterology & GI Surgery, #17 in Pulmonology.
Top 15 Overall Ranking Nationally:  Yes (8th)

Stanford Hospital
Location:  Stanford, CA
Beds:  476
Nationally Ranked Adult Specialties:  13 of 16
Top 10 Rankings: 2 specialties (#9 in Ear, Nose & Throat and #10 in Cancer)
Other Top 20 Rankings:  5 specialties
#11 in Gynecology, #13 in Rheumatology, #13 in Diabetes & Endocrinology, #18 in Cardiology & Heart Surgery, #18 in Urology.
 Top 15 Overall Ranking Nationally:  Yes (15th)

University of Washington Medical Center
Location:  Seattle, WA
Beds:  450
Nationally Ranked Adult Specialties:  12 of 16
Top 10 Rankings:  2 specialties (#4 in Rehabilitation, #5 in Cancer)
Other Top 20 Rankings: 3 specialties (#11 in Nephrology, #15 in Ear, Nose & Throat, #20 in Pulmonology)
Top 15 Overall Ranking Nationally:  No

Cedars-Sinai Medical Center
Location:  Los Angeles
Beds: 865
Nationally Ranked Adult Specialties:  12 of 16
Top 10 Rankings:  2 specialties (#6 in Gastroenterology & GI Surgery, #10 in Cardiology & Heart Surgery)
Other Top 20 Rankings: 3 specialties
(#11 in Diabetes & Endocrinology, #12 in Orthopedics, #18 in Neurology & Neurosurgery)
Top 15 Overall Ranking Nationally:  No

To find other teaching hospitals in the Far West and elsewhere, visit our U.S. Teaching Hospitals resource page.

The Southwest's 5 Best Teaching Hospitals

In the most recent U.S. News & World Report rankings of American hospitals, 137 hospitals earned national distinction in at least one of the 16 adult specialties studied in the survey.  10 teaching hospitals in the Southwest earned national recognition in at least 1 adult specialty.  As derived from the U.S. News survey, here are the 5 highest ranking teaching hospitals in the Southwest.

The 5 Best Teaching Hospitals

Mayo Clinic Arizona Campus

Location:  Phoenix
Beds:  268
Nationally Ranked Adult Specialties:  12 of 16
Top 10 Rankings: #9 in Gastroenterology & GI Surgery

Other Top 20 Rankings:  #16 in Geriatrics, #19 in Cancer, #20 in Ear, Nose & Throat.

Top 15 Overall Ranking Nationally: No

Houston Methodist Hospital
Location:  Houston
Beds: 839
Nationally Ranked Adult Specialties:  11 of 16
Top 10 Rankings: #10 in Gastroenterology & GI Surgery

Other Top 20 Rankings:  #16 in Neurology & Neurosurgery, #17 in Pulmonology, #19 in Urology

Top 15 Overall Ranking Nationally: No

Baylor St. Luke's Medical Center
Location:  Houston
Beds: 690
Nationally Ranked Adult Specialties:  4 of 16
Top 10 Rankings: None

Other Top 20 Rankings:  #17 in Cardiology & Heart Surgery, #19 in Diabetes & Endocrinology

Top 15 Overall Ranking Nationally: No

Banner University Medical Center

Location:  Phoenix
Beds: 653
Nationally Ranked Adult Specialties:  4 of 16
Top 10 Rankings: None

Other Top 20 Rankings:  None

Top 15 Overall Ranking Nationally: No

Baylor University Medical Center
Location:  Dallas
Beds: 876
Nationally Ranked Adult Specialties:  3 of 16
Top 10 Rankings: None

Other Top 20 Rankings:  None

Top 15 Overall Ranking Nationally: No

To find other teaching hospitals in the Southwest and elsewhere, visit our U.S. Teaching Hospitals resource page.

Top 5 Teaching Hospitals in the Great Lakes Region

In the most recent U.S. News & World Report rankings of American hospitals, 137 hospitals earned national distinction in at least one of the 16 adult specialties studied in the survey.  As derived from the U.S. News survey, here are the Top 5 Teaching Hospitals in the Great Lakes region.

Top 5 Teaching Hospitals

Cleveland Clinic
Location:  Cleveland, Ohio
Beds:  1,268
Nationally Ranked Adult Specialties:  14 of 16
Top 10 Rankings:  #1 in Cardiology & Heart Surgery, #2 in four specialties (Gastroenterology & GI Surgery, Nephrology, Rheumatology and Urology), #3 in four specialties (Diabetes & Endocrinology, Gynecology, Orthopedics and Pulmonology), #6 in Ophthalmology, #7 in Ear, Nose & Throat, #8 in Neurology & Neurosurgery, #10 in Geriatrics.

Other Top 20 Rankings:  #12 in Cancer

Top 15 Ranking Nationally:  Yes (#5 overall) 

Northwestern Memorial Hospital
Location:  Chicago, IL
Beds:  885
Nationally Ranked Adult Specialties:  13 of 16
Top 10 Rankings:  #7 in Diabetes & Endocrinology, #8 in Urology, #9 in Orthopedics, #9 in Cardiology & Heart Surgery, #10 in Neurology & Neurosurgery.

Other Top 20 Rankings:  #12 in Geriatrics, #13 in Gastroenterology & GI Surgery, #13 in Rheumatology, #15 in Nephrology, #16 in Cancer.

Top 15 Ranking Nationally:  Yes (#11 overall).

University of Michigan Hospitals and Health Centers
Location:  Ann Arbor, MI
Beds:  899
Nationally Ranked Adult Specialties:  11 of 16
Top 10 Rankings:  #10 in Ophthalmology and #10 Urology
Other Top 20 Rankings:  #13 in Ear, Nose & Throat and #15 in Pulmonology.
Top 15 Ranking Nationally:  No

IU Health Academic Health Center
Location:  Indianapolis, IN
Beds: 1,371
Nationally Ranked Adult Specialties:  10 of 16
Top 10 Rankings:  None
Other Top 20 Rankings:  #14 in Pulmonology, #17 in Gastroenterology & GI Surgery, #17 in Urology

Top 15 Ranking Nationally:  No

University of Wisconsin Hospital and Clinics
Location:  Madison, WI
Beds: 530
Nationally Ranked Adult Specialties:  10 of 16
Top 10 Rankings:  None
Other Top 20 Rankings:  #13 in Nephrology, #18 in Gynecology, #20 in Urology
Top 15 Ranking Nationally:  No

To find other teaching hospitals in the Great Lakes region and elsewhere, visit our U.S. Teaching Hospitals resource page.

The Mid-East Region's Top 5 Teaching Hospitals

137 hospitals earned national distinction in at least one of the 16 adult specialties studied in the most recent U.S. News & World Report rankings of American hospitals.  An examination of those rankings reveals that some of the very best teaching hospitals in the U.S. are based in the Mid-East region of the country.  Today we take a look at the top 5 teaching hospitals in the region as derived from the U.S. News study.

Top 5 Teaching Hospitals

The 951 bed, Baltimore based, Johns Hopkins Hospital is not just the top teaching hospital in the region, it is one of the very best hospitals in the nation, earning 3rd place nationally in the U.S. News rankings.  Johns Hopkins earned distinction in 15 of 16 adult specialties studied in the U.S. News survey.  This includes best in the nation in Rheumatology, 3rd best nationally in 4 other specialties (Ear, Nose & Throat, Neurology & Neurosurgery, Ophthalmology, and Psychiatry) and top 10 rankings in 6 more specialties (Cancer, Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Nephrology and Urology).  Johns Hopkins also has strong credentials in children's medicine as it earned national distinction in 10 of 10 pediatric specialties examined in the U.S. News study.

New York-Presbyterian University Hospital of Columbia and Cornell, based in New York City, also earned national recognition in 15 adult specialties.  This 2,262 bed teaching hospital is #1 in the nation in Psychiatry, #3 nationally in three specialties (Cardiology & Heart Surgery, Nephrology and Rheumatology) and ranks in the top 12 nationally in seven other specialties (Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Neurology & Neurosurgery, Pulmonology, Rehabilitation and Urology).  Like Johns Hopkins, New York-Presbyterian has a strong presence in children's medicine, earning national rankings in 10 pediatric specialties.  New York-Presbyterian is also rated as a top 10 hospital nationally in the most recent U.S. News survey.

Hospitals of the University of Pennsylvania-Penn Presbyterian, which is nationally ranked in 13 adult specialties, is the third highest ranking teaching hospital in the Mid-East region.  Based in Philadelphia, this 784 bed teaching hospital ranks in the top 10 nationally in four specialties (Ear, Nose & Throat, Cardiology & Heart Surgery, Diabetes & Endocrinology and Pulmonology) and in the top 15 nationally in seven other adult specialties. Penn Presbyterian is not only a leading teaching hospital in the Mid-East region, the U.S. News study rates it among the 10 best nationally, too.

UPMC-University of Pittsburgh Medical Center also ranks nationally in 13 adult specialties.  UPMC, which has 1,528 beds, ranks in the top 10 nationally in five adult specialties (Ear, Nose & Throat, Gastroenterology & GI Surgery, Rheumatology, Psychiatry and Orthopedics) and in the top 15 nationally in 3 others.  Although ranking in the same number of adult specialties as Penn Presbyterian, and ranking in the top 10 nationally in one more specialty, overall UPMC scored below its in-State neighbor in the U.S. News survey as it had fewer top 15 and top 25 rankings.  That said, UPMC is definitely one of the preeminent hospitals in the country, earning a top 15 spot nationally in the U.S. News rankings.

Rounding out the Mid-East Region's Top 5 Teaching Hospitals is the 791 bed, New York City based, NYU Langone Medical Center.  NYU Langone Medical Center ranks nationally in 12 adult specialties, with top 10 rankings in five specialties (Orthopedics, Geriatrics, Neurology & Neurosurgery, Rheumatology and Rehabilitation).  Among all hospitals nationally, NYU Langone Medical Center earned recognition in the U.S. News study as among the top 15 hospitals in the country.

To find other teaching hospitals in the Mid-East region and elsewhere, visit our U.S. Teaching Hospitals resource page.

The Top 5 Teaching Hospitals in the Southeast

Only 137 hospitals in the U.S. earned national recognition in at least one of the 16 adult specialties examined in the most recent U.S. News & World Report rankings of American hospitals.  Fourteen of the hospitals earning such a distinction are teaching hospitals from the Southeast. Based on those rankings, here are the Top 5 Teaching Hospitals in the Southeast.

The 819 bed, Duke University Hospital in Durham, North Carolina, holds the highest position among teaching hospitals in the Southeast as derived from the U.S. News rankings.  Duke University Hospital earned national rankings in 12 of 16 adult specialties, including top 10 national rankings in four of those specialties (Urology, Pulmonology, Ophthalmology and Cardiology & Heart Surgery).  In three other specialties (Diabetes & Endocrinology, Nephrology, and Rheumatology) it ranked in the top 20 nationally. 

Emory University Hospital in Atlanta also earned national rankings in 12 of 16 adult specialties, although it earned no top 10 rankings in any specialty.  That said, this 579 teaching hospital earned top 20 rankings in five specialties (Cardiology & Heart Surgery, Diabetes & Endocrinology, Geriatrics, Neurology & Neurosurgery, and Ophthalmology).  In three other adult specialties (Cancer, Gynecology and Urology), Emory University Hospital earned top 30 national rankings.

Florida Hospital Orlando, with more than 2,200 beds, earns a spot among the Top 5 Teaching Hospitals in the Southeast on the strength of its national rankings in 9 of 16 adult specialties.  It's strongest specialties are in Gynecology, where it ranks 13th nationally, and Diabetes & Endocrinology, where it ranks 16th.  In two other specialties, Urology and Geriatrics, it earned top 30 rankings nationally per the U.S. News survey.

Based in Nashville, the 966 bed Vanderbilt University Medical Center earned national rankings in 8 of 16 adult specialties.  This includes two top 10 national rankings, in Urology and Nephrology, and two more top 20 rankings nationally, in Pulmonology and Ear, Nose & Throat.

It is a close contest for the last spot on the list of the The 5 Best Teaching Hospitals in the Southeast.  The 853 bed, Winston-Salem, North Carolina based, Wake Forest Baptist Medical Center, has national rankings in 7 adult specialties, including 17th best nationally in Cancer and 18th best in Nephrology.  The 946 bed, Gainesville, Florida based, UF Health Shands Hospital also has national rankings in 7 adult specialties, but only one top 20 national ranking (13th in Nephrology) and fewer top 30 and top 40 rankings than does Wake Forest Baptist.  So while Wake Forest Baptist earned marginally better recognition in its adult specialties per the U.S News survey, in our estimation UF Health Shands merits honorable mention as one of the top all around teaching hospitals in the Southeast.

To find other teaching hospitals in the Southeast and elsewhere, visit our U.S. Teaching Hospitals resource page.

Top Teaching Hospitals in the Southeast

The Mental Health Care Shortage by Region

Areas and population groups that are served by fewer than 1 psychiatrist for every 30,000 people earn from the Health Resources and Services Administration (HRSA) designation as a mental health care shortage region.  Over 4,000 population groups, with approximately 114 million residents,  have been designated as mental health care shortage areas by the HRSA.  The HRSA further estimates that more than 2,600 additional psychiatrists are needed nationally to eliminate these shortage area designations.  To get a perspective on the severity of the mental health care shortage by region, we aggregated HRSA State-level data into regions based on classifications used here by the U.S. Bureau of Economic Analysis.

To measure the relative severity of the mental health care shortage from one region to the next, we used a metric that we call the shortage quotient.   This quotient compares a region's share of the national mental health practitioner deficit against that area's share of the overall national population that live in shortage areas.  For example, if a specific region had a psychiatrist deficit that was 4% of the national shortfall, and that region's population accounted for 5% of the national population that lived in mental health care shortage areas, then its shortage quotient would be 0.80 (4% divided by 5%).  A shortage quotient below 1.0 would mean an region's psychiatrist shortage would be less severe than the national average, whereas a shortage quotient above 1.0 would mean the region had a more severe shortage of psychiatrists than the national average.

As of August 2015, HRSA data indicates that, on a relative basis, the region with the most severe mental health care shortage was New England.  Although most other regions had a bigger share of the national mental health practitioner deficit, the shortage in New England was proportionately worse than all other regions.  It's 4.7% share of the national mental health practitioner deficit is disproportionately large considering that the region only accounts for 3.2% of the national population living in designated mental health care shortage areas according the the HRSA.  Excluding U.S. Territories, the mental health care shortage by region breaks down as follows:  

The 5 Best Teaching Hospitals in the Plains Region

Only 137 hospitals, out of almost 5,000 hospitals in the U.S., earned national recognition in at least one of the 16 adult specialties examined in the most recent U.S. News & World Report rankings of American hospitals.  Nine of those 137 were Plains Region teaching hospitals.

Atop the list of the 5 Best Teaching Hospitals in the Plains Region is the internationally renown Mayo Clinic.  Based in Rochester, Minnesota, the Mayo Clinic rated not only as the best regionally, but 2nd best in the entire nation.  With more than 1,100 beds, the Mayo Clinic earned national rankings in 15 of 16 adult specialties, including best in the nation rankings for 8 specialties (Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology & Neurosurgery, Pulmonology, and Urology).

St. Louis based Barnes-Jewish Hospital earned national rankings in 14 of 16 specialties, with its strongest specialty being Pulmonology, where it ranked 8th nationally.  With over 1,300 beds, Barnes-Jewish Hospital is one of the preeminent teaching hospitals both regionally and nationally.

The 623 bed, Kansas City based, University of Kansas Hospital earned national rankings in 12 specialties.  Pulmonology and Geriatrics were its strongest specialties, where it ranked 17th nationally in both areas.

The University of Iowa Hospital, the 685 bed teaching hospital based in Iowa City, ranked 7th nationally in Ophthalmology and 8th nationally in the Ear, Nose & Throat specialty.  Overall, the University of Iowa Hospital earned national rankings in 7 specialties.

Rounding out the the 5 Best Teaching Hospitals in the Plains Region is St. Luke's Hospital in Kansas City.  This 410 bed teaching hospital earned national rankings in 7 specialties.  Its two best specialties were Gynecology, where it ranked 19th nationally, and Cardiology & Heart Surgery where it ranked 20th.

To find other teaching hospitals in the Plains Region and elsewhere, visit our U.S. Teaching Hospitals resource page.

Best Teaching Hospitals in the Plains Region

Verifying Florida Health Licenses

According to recent data from the U.S. Bureau of Labor Statistics, well over 450,000 Floridian's are employed as healthcare practitioners.  This includes a wide variety of occupations, ranging from doctors and nurses to orthotists and prosthetists.  More than a dozen regulatory boards are involved in licensing healthcare practitioners in the State.

Florida, like most States, provides online tools that allow the general public to verify the health license status of practitioners that are licensed by the State.  Through Florida's health license verification portal, visitors can lookup the license status for more than 120 health profession designations. This includes checking on the health license status of  doctors, dentists, pharmacists, physician assistants, nurses, podiatrists, optometrists, occupational therapists, physical therapists and acupuncturtists.  Moreover, the Florida health license verification tool provides search results that includes a drilldown feature that offers additional information about each licensee.

To access Florida's primary online health license verification tool, visit our Florida Medical License Lookup page.  Besides the Florida's primary health license verification tool, it includes links to two other important online license status tools operated by the State.  One is the State operated portal to verify the license status of insurance professionals, for those wanting to confirm the license status of health insurance agents and brokers.  The other online tool is one that permits user to verify the license status of Florida's institutional healthcare providers, like hospitals, surgery centers and nursing homes.

Strong Job Outlook for APRNs

With employment projected to grow 31% from 2012 to 2022, the job outlook for Advanced Practice Registered Nurses (APRNs) is a strong one.  By comparison, the Bureau of Labor Statistics (BLS) is anticipating 11% job growth for all occupations in the U.S. during the same period.  Advanced Practice Registered Nurse occupations include nurse anesthetists, nurse midwives, and nurse practitioners.  All three of these APRN occupations are forecast by the BLS to experience much faster than average job growth.  The number of nurse anesthetist jobs is expected to reach 43,900 positions in 2022, up 25% from 2012.  Nurse midwife positions are projected to have an even faster 29% growth rate as the number of nurse midwife jobs is expected to reach 7,700 in 2022, up from 6,000 such positions in 2012.  Nurse practitioners held over 110,000 positions in 2012, making it the largest of the APRN occupations.  Even so, according to the BLS nurse practitioners have the strongest job growth outlook among the APRN occupations as the number of nurse practitioner jobs is expected to grow 34%, to 147,300 positions, from 2012 to 2022.

The strong job outlook for APRNs is underpinned by robust growth in the demand for healthcare services. Several factors, including the Affordable Care Act and its positive impact on the overall number of Americans with health insurance coverage, the increased emphasis on preventative care, and the large, aging baby-boom population will contribute to growing demand for healthcare services.

Also underlying the strong job outlook for APRNs are legislative trends that are gradually expanding the profession's practice authority to include more primary care services traditionally rendered by physicians.  In addition, APRNs  are becoming more widely recognized by the public as a source for primary healthcare, another ongoing development that will boost job growth prospects for the profession.

For a look at the job outlook for other health professions, visit Healthcare Job Outlook.

 

The Primary Care Shortage by Region

Areas and population groups that are served by fewer than 1 primary care physician for every 3,500 people earn a shortage area designation from the Health Resources and Services Administration (HRSA).  Approximately 6,100 population groups, encompassing more than 60 million residents,  have been designated as primary care shortage areas by the HRSA.  The HRSA further estimates that nearly 8,100 additional primary care physicians are needed nationally to eliminate these shortage area designations.  To get a perspective on the severity of the primary care shortage by region, we aggregated HRSA State-level data into regions based on classifications used here by the U.S. Bureau of Economic Analysis.

Measuring the severity of the shortage in a given area can take several forms.  A metric that we like is something we call the shortage quotient.   This quotient compares a shortage area's share of the national practitioner deficit against that area's share of the national population that live in shortage areas.  For example, if a specific shortage area had a practitioner shortfall that was 5% of the national shortfall, and that area's population accounted for 4% of the national shortage area population, then its shortage quotient would be 1.25 (5% divided by 4%).  A shortage quotient below 1.0 would mean an area's provider shortage would be less severe than the national average, whereas a shortage quotient above 1.0 would mean the population group had a more severe shortage problem.

As of May, 2014, the biggest deficit was in the Southeast region in absolute terms, where more than 2,360 additional primary care physicians are needed to eliminate shortage conditions.  While that figure represents over 29% of the total primary care physician shortage nationally, the Southeast region holds slightly more than 30% of the population nationally that live in designated shortage areas.  Consequently, the Southeast's shortage quotient is just under 1.0, indicating that it's primary care shortage is on par with the nation as a whole.  The shortage quotient metric reveals that the most severe shortage conditions exist in New England, even thought the region has the smallest primary care physician shortage in absolute terms with a deficit of just 242 providers, or about 3.0% of the national total.  However, that share of the national primary care physician deficit is actually disproportionately large considering that New England only holds about 1.8% of the national population living in designated primary care shortage areas.  These conditions give the New England region a primary care shortage quotient of 1.65 (3% share of national provider deficit divided by 1.8% of the national shortage area population), giving it the worst shortage quotient of any region in the U.S.  

The 10 Worst States for Health Services Management Pay

There were just over 310,000 health service management jobs in the U.S. according to May 2014 data published by the U.S. Bureau of Labor Statistics (BLS).  Health service management positions encompass a variety of supervisory and managerial jobs in healthcare settings, ranging from health information administrators to health system executives.  Although not on par with the average annual pay for many skilled healthcare occupations, BLS data puts the national mean wage of health service managers at $103,700 per year, well above the $47,200 mean annual wage for all occupations in the U.S.

Excluding the District of Columbia, California recorded the highest average pay scale for health services managers at just over $122,400 per year.  At the opposite end of the spectrum was Idaho, where the average pay was a bit less than $78,400 per year.  In all, BLS data shows nineteen (19) States where the annual mean wage for health service managers is in excess of the national mean, and thirty-one (31) States where the mean annual wage is below the national average.

Joining Idaho among The 10 Worst States for Health Services Management Pay are the following:

Go to Health Services Managers Average Wages by State to see where your State ranks.

The Top 10 Medicare Prescription Drug Plan Providers

Medicare Prescription Drug Plans (PDPs)  are a type of health plan designed to provide prescription drug coverage for enrollees of Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. PDPs are offered through private health insurers and other private companies that have been approved by Medicare.

In order to get coverage for their prescription costs, Medicare eligible individuals must either purchase a PDP or opt to get their Medicare coverage through a Medicare Advantage Plan (discussed in a previous commentary) that offers prescription drug benefits.

March 2015 data available from the Centers for Medicare and Medicaid Services (CMS) shows that close to 24 million Americans are now enrolled in Medicare Prescription Drug Plans.

Our compilation of the March 2015 CMS data yields this list of the Top 10 Medicare Prescription Drug Plan Providers:

The Top 10 Medicare Advantage Plan Insurers

Medicare Advantage plans are the increasingly popular type of health plan offered by private insurers as an alternative to original Medicare.  Private insurers 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 stipulated amount to a private insurer 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 insurers have been able to bundle Part A and Part B benefits, plus a variety of extra benefits, into their plans at little to no premium cost to enrollees.

With typically lower costs and additional benefits, MA Plans can be a great value compared to Original Medicare.  Consequently, as we observed in this commentary last month, Medicare Advantage plans have seen strong growth over the past decade.  March 2015 data available from Centers for Medicare and Medicaid Services (CMS) shows over 17.3 million Americans are now enrolled in Medicare Advantage plans, up from 5.3 million in 2004.

Our number-crunching of the March 2015 CMS data yields this list of the Top 10 Medicare Advantage Plan Insurers:

These enrollment figures do not include Medicare Prescription Drug Plans (PDPs) available through private insurers as a supplement to Original Medicare.  Our next commentary will take a look at the top insurers providing Medicare Prescription Drug plans according to the March 2015 CMS data.

Top 10 States for High Pay Health Service Management Jobs

According to May 2014 data available from the U.S. Bureau of Labor Statistics (BLS), there were just over 310,000 health service management jobs in the United States.  An analysis of BLS data reveals that there was a national mean wage for these positions, which encompass a wide range of jobs from health information administrators to health system executives, of $103,700 per year.

The District of Columbia recorded the highest average pay scale for health services managers at just over $131,000 per year.  At the opposite end of the spectrum was Idaho, where the average pay was a bit less than $78,400 per year.  Nineteen States have annual mean wages in excess of the national mean per the BLS.

Counting down the Top 10 States for High Pay Health Service Management Jobs:

Go to Health Services Managers Average Wages by State to see where your State ranks.

Strong Demand Projected for Health Services Managers

There were just over 315,000 people engaged in health services management occupations in 2012 according to the U.S. Bureau of Labor Statistics (BLS).  Per the BLS, strong demand is projected for health services managers through 2022, as employment in these occupations is expected to grow 23% from 2012 levels. This anticipated employment growth is being spurred by demographic and technological trends that have been, and will continue, driving demand growth for healthcare services in general.  This anticipated 23% increase in health services management positions is more than double the 11% growth rate projected for all occupations in the U.S. during the same forecast period. 

This diverse group, which ranges from health information administrators and clinical managers all the way up to senior hospital and health system executives, is integral to the effective functioning of the U.S. healthcare system.  Hospitals, clinics, nursing homes, outpatient service providers, group and individual health practices and many related institutions rely on the operational and administrative expertise of health service management professionals.  While the underlying demand growth for healthcare services points toward a robust expansion of health services management jobs, escalating pressure on healthcare providers to operate more cost effectively will create further opportunities for management professionals who can help providers adapt to this changing operational environment.

For more about this profession, check out Health Services Managers | What Do They Do?

Ten States with the Most Registered Nurses

In the parlance of analysts with the U.S. Bureau of Labor Statistics, a location quotient is measure of an occupation's prevalence in a census area in relation to that occupation's prevalence throughout the nation as a whole.  A location quotient above 1.0 indicates that an occupation has a bigger share of employment in a given census area than it does on a national basis.  On the other hand, a location quotient below 1.0 indicates that an occupation has a smaller share of employment in a particular area than it does nationally.

Looking at just the raw numbers, it is almost always the biggest population States that have the largest employment bases when examining healthcare occupations.  However, a different picture emerges when one looks at a relative measure like the location quotient.  It is smaller States that dominate the list of Ten States with the Most Registered Nurses on a relative basis.

The Ten States with the Most Registered Nurses on an absolute basis is dominated by the large population States, with only Ohio and Massachusetts making the top 10 on both lists.

Ten States with the Most Primary Care Physicians

The Health Resources and Services Administration (HRSA) reports that the United States has roughly 74.5 primary care physicians for every 100,000 residents.  For HRSA purposes, primary care physicians include non-federal osteopaths and physicians who are not hospital residents and who have a declared practice specialty in General Practice, General Family Medicine, General Internal Medicine or General Pediatrics.

Per HRSA studies, The Ten States with the Most Primary Physicians, on a per capita basis, come from the Northeast as indicated here:

A more detailed examination of the underlying data reveals that outside the Northeast, the only states with top ten primary care coverage were Oregon and Minnesota.

Note:  National rank includes the District of Columbia, which is #1 nationally with 113.9 PCPs per 100,000 residents.

Medical Assistant Employment Projected to Grow 29%

The medical assistant job outlook through 2022 looks solid according to estimates from the U.S Bureau of Labor Statistics (BLS).  Medical assistant jobs are projected to grow 29% from 2012 to 2022, significantly better than the 11% average the BLS projects for all occupations during this period. The BLS projects that by 2022 the number of medical assistant jobs in the U.S. will reach almost 724,000 positions, an increase of about 163,000 jobs from 2012 levels.

A growing population of aging baby-boomers will continue to spur demand for preventive medical services, much of which will be provided by physicians. In addition, the Affordable Care Act is expanding the number of patients who have access to health insurance, which in turn will increase patient access to medical care.  As physician practices expand to support growing demand for healthcare services, demand for medical assistants to perform supportive administrative and clinical duties will continue expanding too.

Besides physician practices, a growing number of clinics, group practices, and other healthcare facilities will be needing more support workers, particularly medical assistants, to meet both administrative and clinical duties as overall demand for healthcare services continues its growth.

Further boosting demand for medical assistants will be the continuing evolution of health information technology within the health administration environment.  Implementation of electronic health record (EHR) technologies and protocols will very likely create new and changing tasks for medical assistants as part of the medical team. As more and more provider practices incorporate electronic health records (EHRs) into their administrative structure, medical assistants’ job responsibilities will expand accordingly. Medical assistants will undoubtedly need to become familiar with EHR computer software, including maintaining EHR security and analyzing electronic data, to improve healthcare information.

To learn more, visit Medical Assistants, What Do They Do?

Out of Pocket Health Expenditures Then and Now

In 2013 U.S. consumer out of pocket health expenditures topped $339.4 billion according to federal authorities. That is roughly $1,080 for every person in the U.S. - and that is just the out of pocket portion of the nation's health expenditures.  In 2013 out of pocket health expenditures accounted for just under 12% of national health costs, which overall were close to $9,300 per person.  Out of pocket health expenditures in 2013 were close to 14X greater than they were in 1963.  As amazing as the growth in out of pocket expenditures seems, it is actually slower than the overall growth in our national health expenditures in that 50 year span.  Thanks to broader private insurance coverage and the expansion of federal and state health insurance programs like Medicare and Medicaid, consumer out of pocket health expenditures today account for far less of national health expenditures than they did 50 years ago.

A closer look at the details reveals striking differences in how big a share of health expenditures consumers had to pay out of pocket for medical services in 1963 versus fifty years later. 

Demand for Physical Therapists Projected to Grow 23% by 2025

A recently released report from the National Center for Health Workforce Analysis (NCHWA) projects that demand for physical therapists will grow 23% between 2012 and 2025.  Favorable demographic trends, with the U.S. population growing larger and the senior population growing even faster, improved insurance coverage thanks to the benefits of the Affordable Care Act, and more focus on chronic illness management all point to growing demand for physical therapy services.

Notwithstanding the trends that point to strong growth in demand for physical therapists, the NCHWA report does not foresee a tight national labor market for physical therapists.  According to the NCHWA assessment, anticipated growth in new entrants to the physical therapy field should allow the workforce to grow at a faster rate than demand, even after taking into account retirement and attrition in the physical therapist labor force.  Consequently, the NCHWA report is forecasting that the U.S. should have more than enough supply to cover growing demand for physical therapy services over the next decade.

For more information about physical therapists, visit this Physical Therapist resource.  To review the workforce report in its entirety, go to NCHWA Health Workforce Projection.

Ten States with the Fewest Primary Care Physicians

Based upon the most recent data analysis (December 2012) from the HRSA, in the United States there were approximately 74.5 primary care physicians for every 100,000 residents.  In HRSA studies primary care physicians include non-federal doctors and osteopaths who are not hospital residents and whose principal activity is defined as patient care.  Moreover, these doctors and osteopaths have a declared practice specialty as a General Practitioner or in General Family Medicine, General Internal Medicine or General Pediatrics.

The Ten States with the Fewest Primary Physicians, on a per capita basis, come from the South or the West as indicated here:

A more detailed examination of the underlying numbers available from the HRSA reveal Mississippi as having the fewest primary care physicians per capita of any State.  Texas and Georgia, despite being two of the ten largest population states, were among the among the Ten States with the Fewest Primary Care Physicians.  Although both states have sizable raw physician numbers, the number of primary care physicians in each state is small relative to the overall population base.

Note:  National rankings include the District of Columbia

A Look at Medicare Advantage Enrollment Growth

Typically structured with more benefits and lower costs than standard Medicare coverage, Medicare Advantage Plans present a good value for many seniors.  As we noted in this commentary last June, that added value if often a product of managed care protocols and more selective provider networks than found with standard Medicare coverage.  While those features might be less appealing to some consumers, Medicare Advantage plans have nevertheless experienced robust growth over the past five years, growing from 23% to 30% of the total Medicare population. In the most recent Medicare annual enrollment period, which ended 12/31/14, Medicare Advantage applications were up another 8% from the prior year, so enrollment should exceed 16.5 million members in the current plan year.

Bob Brecht of DMN3 provides some constructive insight into the various factors that have been driving this trend in his recent blog post What's Fueling the Growth of Medicare Advantage Plans?

Pharmacists per 100,000 Population

According to workforce health professions sample data taken from the American Community Survey (ACS) done by the U.S. Census Bureau, the Health Resources and Services Administration estimates that there are approximately 272,000 pharmacists in the United States.  That equates to just over 87 pharmacists to serve every 100,000 U.S. residents.  With an aging population, expanded health insurance coverage and ongoing new drug developments, the job outlook for Pharmacists is considerably better than the outlook for most professions. Nevertheless, with many States actually having a much heavier concentration of pharmacists than the nation as a whole, the pharmacist job outlook over the next decade will be much less certain in some regions of the country than it is in others.

From the HRSA data portal, here is the latest look at Pharmacists per 100,000 population:

Current and prospective pharmacists looking for better opportunities might want to consider these ten states where the number of pharmacists per capita is well below the national average:

The Tele-Health Booth

In this interview, executives from Health for Development (H4D) discuss their new tele-health booth, which permits remote physicians to gather a broad spectrum of basic diagnostic information from patients who use the H4D booth.  Referred to as the "Consult-Station", this new tele-health platform is being introduced in France and could find its way to parts of Africa in the near future.

A Registered Nurse Glut on the Horizon?

Time and again we have heard news reports that point to a shortage of registered nurses throughout much of the country.  With demand for healthcare services on the rise, spurred by technical advances in medical care, a growing population generally and an expanding seniors population in particular, the conventional wisdom in most circles is that the registered nurse shortage will likely worsen in the coming years.

To be sure, nursing schools are turning out new RNs at good clip, but with lots of baby-boom era nurses heading for retirement themselves, the conventional wisdom is that the overall growth in the supply of registered nurses is not keeping pace with current and anticipated demand growth for healthcare services.  The U.S. Bureau of Labor Statistics (BLS) projects registered nurse employment will grow by more than 525,000 jobs between 2012 and 2022.  Moreover, taking into account the need to replace RNs who will be retiring or leaving the workforce, the BLS anticipates more than 1,000,000 registered nurse positions will need to be filled in that same time period (see Line 6 in this BLS report). 

Given the BLS forecasts and the steady flow of news warning of nursing shortages, we were interested to discover this report, The Future of the Nursing Workforce: National and State Level Projection, 2012-2025, issued last month by the National Center for Workforce Analysis (NCWA), a unit of the Health Resources and Services Administration, which itself is a part of the U.S. Department of Health and Human Services.  This NCWA study projects that changing demographics and broader insurance coverage will require an additional 612,000 registered nurses by 2025.   While this is a seemingly good trend for current and prospective registered nurses, the NCWA analysis foresees the supply of RNs to grow at an even faster clip.  Despite projected attrition of nearly 1 million RNs from the workforce over the next decade, at the rate nursing schools are turning out RNs, The NCWA expects that almost 2 million new registered nurses will be joining the workforce during this period. So by 2025, the supply of registered nurses will grow by 952,000 in the NCWA analysis.  If that happens, by 2025 we could see 340,000 more registered nurses nationally than there will be registered nursing positions.

It is important to note that in the NCWA forecast model it is assumed that registered nurse supply and demand were equal in 2012.  Nurse hiring managers might disagree with that assumption.  That said, the NCWA analysis infers that the growing number of net new entrants into the registered nursing profession will materially outpace demand growth over the next decade.  If that is the case, whatever RN shortage we have today will, at a minimum, dissipate in coming years and, if the NCWA forecast is realized, could turn into a registered nurse glut over the next decade.

Physician Assistants per 100,000 Population

From the Health Resources and Services Administration, a look at physician assistants per 100,000 population in 2013:

The national average was a bit more than 34 PAs per 100,000 population in 2013.  Among States with strong physician assistant density (in darker blue), Alaska was tops with 70.3 PAs per 100,000 residents.  Four other States had more than 50 physician assistants per 100,000 population:  New York, West Virginia, South Dakota and Maine.

At the other end of the spectrum was Mississippi with just 3.9 PAs per 100,000 residents.  Other States with poor PA density (in white) include Alabama, Arkansas, Indiana and Missouri, all of whom had fewer than 15 physician assistants per 100,000 population.

The Top 5 Children's Hospitals in the Southwest

According to the most recent US News and World Report Children's Hospital Rankings for 2014-2015, there were 89 hospitals that earned a national ranking in at least one of ten pediatric specialties covered in the survey.  Although eight pediatric hospitals based in the Southwest (Arizona, New Mexico, Oklahoma and Texas) earned at least one national ranking in a pediatric specialty, only one - Texas Children's Hospital (map) in Houston - landed on the US News Best Children's Hospital Honor Roll.  The Honor Roll recognized the 10 highest ranked children's hospitals in the United States.  Ranked 4th best nationally, the highest national rank of any children's hospital west of the Mississippi, Texas Children's Hospital ranked in the top 35 in all 10 pediatric medicine specialties covered in the US News survey, including in the top 10 nationally in nine specialties.  In six of those pediatric specialties (cardiology and heart surgery, neonatology, cancer, nephrology, pulmonology, and gastorenterology/GI surgery) Texas Children's, a teaching hospital affiliate of the Baylor College of Medicine, ranked in the top 5 nationally.  Without a doubt, Texas Children's Hospital sits atop the list of the Top 5 Children's Hospitals in the Southwest.

With top 35 rankings in eight specialties in the US News survey, second on the list of the Top 5 Pediatric Hospitals in the Southwest would be Children's Medical Center Dallas (map).  Children's Medical Center Dallas, which is the primary pediatric teaching hospital of the University of Texas Southwestern medical school, earned top 10 national rankings in two specialties (#5 orthopedics and #10 urology) and top 20 national rankings in two others.

Sitting at third on the list of the Top 5 Children's Hospitals in the Southwest would be  Cook Children's Hospital in Fort Worth.  Ranked nationally in the top 50 in seven specialties in the US News survey, Cook Children's Hospital's two best rankings were in pulmonology (#28) and diabetes and endocrinology (also #28).

Phoenix Children's Hospital occupies 4th place on the list of the Top 5 Children's Hospitals in the Southwest based on the US News survey results.  Phoenix Children's ranked nationally in 4 pediatric medicine specialties, with its best rankings being in cancer (#36) and cardiology and heart surgery (#40).

Rounding out the list of the Top 5 Children's Hospitals in the Southwest is The Children's Hospital at OU Medical Center in Oklahoma City.  The Children's Hospital at OU Medical Center earned national top 50 rankings in two pediatric specialties, orthopedics and urology.

 While not placing on the list of the Top 5 Children's Hospitals in the Southwest, three other hospitals in the region earned one national ranking in a pediatric medicine specialty in the US News survey:

Children's Cancer Hospital and UT MD Anderson Cancer Center (#42 in cancer)
Children's Memorial Hermann Hospital in Houston (#25 in diabetes and endocrinology)
Dell Children's Medical Center of Central Texas in Austin (#49 in urology)