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.