Wednesday, December 30, 2020

The Dental Care Shortage in New England

Data released from September 2020 by the Health Resources and Services Administration (HRSA) revealed that nearly 60 million Americans lived in a dental care shortage areas. These areas, known as a Health Professional Shortage Area (HPSA) by the HRSA, are geographic areas, population groups, or facilities where access to healthcare services is substandard because it lacks a sufficient number of primary care, dental care, or mental health care providers. With respect to dental care, HRSA designation is based upon the number of people living within the HPSA relative to the number of dentists and dental auxiliaries (any non-dentist staff employed by the dentist to assist in the operation of the practice) that service the area.  Although the population-to-provider ratio needed to qualify for designation varies by HPSA type (geographic, population or facility), all HPSAs with a dental care shortage designation have a population-to-provider ratio that meets or exceeds certain limits set by federal regulations. HRSA designated dental care shortage areas are eligible to participate in federal programs aimed at attracting more dental care providers to work with these communities. As of September 2020, close to 6,500 areas or settings qualified with the HRSA as a dental care shortage area. To eliminate all such designations, the HRSA estimates that these HPSAs would need about 10,700 additional dental care providers.

HPSAs in New England account for about 2.1% of the U.S. population who live in dental care shortage areas and roughly 1.8% of the national shortage of dental care providers. The HRSA estimates that HPSAs in New England would need about 200 additional dental care providers in order to eliminate the dental care shortage in the region. Here is a summary look at the dental care shortage in New England:

The Dental Care Shortage in New England

The Dental Care Shortage in New England

State (1) HPSAs (2) Population (3) Shortage
CT 38 394.8 100
ME 81 329.7 45
MA 56 325.2 21
NH 22 28.5 5
RI 14 160.5 23
VT 14 29.4 2
Region 225 1,268.1 196
U.S. 6,487 59,941.1 10,716

(1) Designated Geographic, Population Group and Facility HPSAs with a dental care shortage
(2) Population of designated HPSAs, in thousands
(3) Dental Care practitioners needed to remove HPSA Designation

Source:  Designated HPSA Quarterly Summary, 9/30/20 (HRSA)

Tuesday, December 29, 2020

The Primary Care Shortage in the Far West

September 2020 reports from the Health Resources and Services Administration (HRSA) tell us that over 81 million Americans lived in a primary care shortage area. Known by the HRSA as a Health Professional Shortage Area (HPSA), a HPSA with a primary care shortage is a geographic area, population group, or facility where access to basic healthcare services is substandard because of a lack of primary care providers. This HRSA designation is based upon the number of people living within the HPSA relative to the number of primary care providers that service the area. For its purposes, the HRSA considers "primary care" providers to include MDs and DOs (Doctors of Osteopathy) who provide services as general or family practitioners, general internal medicine physicians, pediatricians, obstetricians or gynecologists. Although the population-to-provider ratio needed to qualify for primary care shortage area designation varies by HPSA type (geographic, population or facility), all HPSAs with a primary care shortage designation have a population-to-provider ratio that meets or exceeds certain thresholds set by the federal government. HPSA's receiving a primary care shortage area designation are eligible to participate in federal programs aimed at attracting more primary care service providers to their communities. As of September 2020, the HRSA estimates that all primary care shortage areas in the U.S. would need nearly 15,000 more primary care providers to eliminate all such shortage designations.

HPSAs in the six-state Far West region account for about 16.2% of the U.S. population who live in primary care shortage areas and just under 17.8% of the national shortage of primary care providers. To eliminate these shortages, the HRSA estimates that Far West region shortage areas would need 2,654 additional primary care providers. Here is a summary look at the primary care shortage in the Far West region of the United States:

The Primary Care Shortage in the Far West
The Primary Care Shortage in the Far West

State (1) HPSAs (2) Population (3) Shortage
AK 301 231.8 59
CA 626 7,996.8 1,545
HI 31 507.3 80
NV 72 950.4 171
OR 144 911.4 143
WA 200 2,643.1 656
Region 1,374 13,240.8 2,654
U.S. 7,203 81,516.3 14,945

(1) Designated Geographic, Population Group and Facility HPSAs with a primary care shortage
(2) Population of designated HPSAs, in thousands
(3) Primary Care practitioners needed to remove HPSA Designation

Source:  Designated HPSA Quarterly Summary, 9/30/20 (HRSA)

Monday, December 28, 2020

The U.S. Environmental Protection Agency, our trusted link for December, 2020

The U.S. Environmental Protection Agency is an independent executive agency established in 1970 by President Richard Nixon. To insure a cleaner, healthier environment, the EPA performs research, monitors the water, air, products, and land across the U.S. It sets safety standards, writes regulations, and works with the states to enforce them. 

Its accomplishments include

More than half the EPA employees are engineers, scientists and environmental protection specialists. The sectors they research for environmental and health impact include agriculture, forestry, manufacturing, mining, transportation, and utilities for water, sewage, and electricity. Resources they provide to the public include

Their basic research programs include

Over a dozen Hotlines are available for reporting and inquiring about issues including asbestos, drinking water, oil pollution, pesticides, and toxic substances. 

In addition to subscribing to their news releases, you can follow their work on

Visit the Interactive Mold House for safety tips

Physical Therapy Assistant Pay in the Top 20 Metro Areas

According to the U.S. Bureau of Labor Statistics (BLS), there were about 97,000 physical therapy assistants (PTA) employed in the U.S. as of May 2019. Physical therapy assistants are employed in a variety of healthcare settings, including offices of non-physician practitioners, hospitals, home health care agencies, skilled nursing facilities, and in physician offices. With some advanced technical skills and training, PTA's generally earn slightly better salaries than workers in most occupations. The BLS reported that, as of May 2019, the national mean salary for PTAs was $58,520 per year, a bit more than 9% above the $53,490 annual mean salary for all occupations in the United States.  May 2019 BLS data tells us the following about physical therapy assistant pay in the top 20 metro areas in the USA:

Metropolitan Area # Employed Annual Mean Wages
1 New York-Newark-Jersey City 4,610 $60,160
2 Los Angeles-Long Beach-Anaheim 1,770 $67,480
3 Chicago-Naperville-Elgin 2,670 $60,760
4 Dallas-Fort Worth-Arlington N/A N/A
5 Houston-The Woodlands-Sugar Land 1,470 $78,530
6 Washington-Arlington-Alexandria 1,520 $53,490
7 Miami-Fort Lauderdale-Pompano Beach 1,790 $61,980
8 Philadelphia-Camden-Wilmington 1,760 $57,390
9 Atlanta-Sandy Springs-Alpharetta 1,450 $52,890
10 Phoenix-Mesa-Chandler 2,130 $43,350
11 Boston-Cambridge-Newton 1,600 $65,500
12 San Francisco-Oakland-Berkeley 810 $63,110
13 Riverside-San Bernardino-Ontario 530 $71,460
14 Detroit-Warren-Dearborn 1,470 $54,560
15 Seattle-Tacoma-Bellevue 810 $62,360
16 Minneapolis-St. Paul-Bloomington 850 $57,680
17 San Diego-Chula Vista-Carlsbad 740 $61,750
18 Tampa-St. Petersburg-Clearwater 790 $65,450
19 Denver-Aurora-Lakewood 840 $55,430
20 St. Louis 1,260 $51,780
National 96,840 $58,520

Source: U.S. Bureau of Labor Statistics OES. Data extracted on December 26, 2020

Sunday, December 27, 2020

Dental Assistant Pay in the Top 20 Metropolitan Markets

According to data released by the U.S. Bureau of Labor Statistics (BLS), there were just over 351,000 dental assistants employed in the U.S. as of May 2019. The overwhelming majority of dental assistants work in dental offices, with small numbers found employed by employment agencies, in physician offices, and in outpatient care centers. While dental assistants must possess some technical understanding, many of their duties can be administrative in nature and don't require the kind of advanced skills or training required by many other healthcare occupations. Dental assistants, on average, earn lower salaries than workers in most other occupations. As of May 2019, the BLS estimated that the national mean salary for dental assistants was $41,170 per year, as compared to the $53,490 annual mean wage for all occupations in the U.S. Pay for the profession varies considerably from region-to-region, with dental assistants in some regions making 50% more than what their professional peers made elsewhere. As of May 2019, BLS data reveals the following about dental assistant pay in the top 20 metropolitan markets in the United States:

Metropolitan Area # Employed Annual Mean Wages
1 New York-Newark-Jersey City 21,780 $42,580
2 Los Angeles-Long Beach-Anaheim 19,440 $39,900
3 Chicago-Naperville-Elgin 10,760 $41,030
4 Dallas-Fort Worth-Arlington 10,310 $41,930
5 Houston-The Woodlands-Sugar Land 7,580 $36,490
6 Washington-Arlington-Alexandria 6,050 $47,860
7 Miami-Fort Lauderdale-Pompano Beach 6,720 $39,180
8 Philadelphia-Camden-Wilmington 6,030 $42,260
9 Atlanta-Sandy Springs-Alpharetta 5,370 $42,400
10 Phoenix-Mesa-Chandler 6,040 $42,280
11 Boston-Cambridge-Newton 6,070 $50,220
12 San Francisco-Oakland-Berkeley 6,980 $51,510
13 Riverside-San Bernardino-Ontario 6,050 $37,560
14 Detroit-Warren-Dearborn 4,340 $37,050
15 Seattle-Tacoma-Bellevue 5,500 $48,070
16 Minneapolis-St. Paul-Bloomington 3,760 $54,510
17 San Diego-Chula Vista-Carlsbad 5,270 $41,550
18 Tampa-St. Petersburg-Clearwater 3,030 $41,380
19 Denver-Aurora-Lakewood 4,490 $44,370
20 St. Louis 2,400 $40,060
National 351,470 $41,170

Source: U.S. Bureau of Labor Statistics OES. Data extracted on December 26, 2020

Saturday, December 26, 2020

The Mental Health Care Shortage in the Southeast

September 2020 data released by the Health Resources and Services Administration (HRSA) indicates that over 119 million Americans lived in mental health care shortage areas. These areas, known as Health Professional Shortage Areas (HPSA) by the HRSA, are geographic areas, population groups, or facilities where access to mental health care services is substandard because of a lack of mental health care providers. In the case of mental health care services, a HRSA shortage designation is based upon the number of people residing within the HPSA relative to the number of mental health care providers that service the area. Certain areas earn a shortage designation based on its population relative to the number of psychiatrists in the area, while others earn designation based upon its population relative to the number of psychiatrists and core mental health providers. For HRSA purposes, core mental health providers include clinical social psychologists, clinical social workers, marriage & family therapists and psychiatric nurse specialists. Although the population-to-provider ratio necessary to qualify for designation varies by HPSA type (geographic, population or facility), all mental health care shortage areas have a population-to-provider ratio that meets or exceeds certain thresholds established by federal regulations. Areas designated as having a mental health care shortage are eligible to participate in federal programs aimed at attracting more mental health care providers to work with these communities. The HRSA estimates that, as of September 2020, all mental health care shortage areas in the U.S. would need about 6,500 more mental health care providers to eliminate all such shortage designations.

The twelve-state Southeast region of the country suffers from the most acute mental health care shortage of all regions of the U.S.  HPSAs in the region account for about 29.7% of the U.S. population who live in mental health care shortage areas and 34.0% of the shortage of mental health care providers nationally.  The HRSA estimates that HPSAs in the Southeast would need nearly 2,200 more mental health care providers in order to eliminate the mental health care shortage in the region.  Here is a summary look at the mental health care shortage in the Southeast:

The Mental Health Care Shortage in the Southeast
The Mental Health Care Shortage in the Southeast

State (1) HPSAs (2) Population (3) Shortage
AL 58 2,927.8 156
AR 48 1,426.3 67
FL 204 6,387.8 388
GA 87 4,911.3 193
KY 112 3,204.3 177
LA 150 3,399.0 159
MS 83 2,375.3 278
NC 178 2,670.8 149
SC 70 2,304.8 112
TN 72 3,224.3 295
VA 73 1,943.5 102
WV 101 708.1 122
Region 1,236 35,483.3 2,198
U.S. 5,733 119,344.0 6,464

(1) Designated Geographic, Population Group and Facility HPSAs with a mental health care shortage
(2) Population of designated HPSAs, in thousands
(3) Mental Health Care practitioners needed to remove HPSA Designation

Source:  Designated HPSA Quarterly Summary, 9/30/20 (HRSA)

Thursday, December 24, 2020

The Dental Care Shortage in the Rocky Mountain Region

A September 2020 report from the Health Resources and Services Administration (HRSA) revealed that close to 60 million Americans lived in dental care shortage areas. These areas, known as a Health Professional Shortage Area (HPSA) by the HRSA, are geographic areas, population groups, or facilities where access to dental care services is substandard because of a lack of dentists and dental auxiliaries (any non-dentist staff employed by the dentist to assist in the operation of the practice). With respect to dental care, HRSA designation criteria is based upon the number of people living within the HPSA relative to the number of dental care providers that service the area. Although the population-to-provider ratio needed to qualify for designation as a dental care shortage area varies by HPSA type (geographic, population or facility), all HPSAs with a dental care shortage designation have a population-to-provider ratio that meets or exceeds certain limits set by federal regulations. Areas receiving a dental care shortage designation by the HRSA are eligible to participate in federal programs aimed at attracting more dental care providers to work with these communities. As of September 2020, nearly 6,500 areas or settings had been designated as dental care shortage areas by the HRSA.  The HRSA estimates that these HPSAs would need about 10,700 additional dental care providers to eliminate all such designations.

HPSAs in the five-state Rocky Mountain region account for about 4.1% of the U.S. population who live in dental care shortage areas and about 3.1% of the national shortage of dental care providers. The HRSA estimates that HPSAs in the Rocky Mountain region would need more than 330 additional dental care providers in order to eliminate the dental care shortage in the region. Here is a summary look at the dental care shortage in the Rocky Mountain region of the United States:

The Dental Care Shortage in the Rocky Mountain Region

The Dental Care Shortage in the Rocky Mountain Region


State (1) HPSAs (2) Population (3) Shortage
CO 100 848.2 137
ID 94 493.8 58
MT 123 351.2 61
UT 62 703.5 73
WY 31 49.7 5
Region 410 2,446.4 334
U.S. 6,487 59,941.1 10,716

(1) Designated Geographic, Population Group and Facility HPSAs with a dental care shortage
(2) Population of designated HPSAs, in thousands
(3) Dental Care practitioners needed to remove HPSA Designation

Source:  Designated HPSA Quarterly Summary, 9/30/20 (HRSA)

Wednesday, December 23, 2020

The Primary Care Shortage in the Southwest

September 2020 reports from the Health Resources and Services Administration (HRSA) indicate that more than 81 million Americans lived in a primary care Health Professional Shortage Area (HPSA). An HPSA with a primary care shortage is a geographic area, population group, or facility where access to basic healthcare services is substandard because of a lack of primary care providers. This HRSA designation is based upon the number of people living within the HPSA relative to the number of primary care providers that service the area. For its purposes, the HRSA considers "primary care" providers to include Doctors of Medicine (MD) or Doctors of Osteopathy (DO) who provide services as family or general practitioners, general internal medicine physicians, pediatricians, obstetricians or gynecologists. Although the population-to-provider ratio needed to qualify for primary care shortage area designation varies by HPSA type (geographic, population or facility), all HPSAs with a primary care shortage designation have a population-to-provider ratio that meets or exceeds certain limits stipulated by federal regulations. HPSA's receiving a primary care shortage area designation are eligible to participate in federal programs aimed at attracting more primary care services to their communities. The HRSA estimates that, as of September 2020, all primary care HPSAs in the U.S. would need nearly 15,000 more primary care providers to eliminate all such shortage designations.

HPSAs in the four-state Southwest region account for about 15.5% of the U.S. population who live in primary care shortage areas and just under 13.3% of the national shortage of primary care providers. To eliminate these shortages, the HRSA estimates that Southwest region HPSAs would need almost 2,000 additional primary care providers. Here is a summary look at the primary care shortage in the Southwest region of the United States:

The Primary Care Shortage in the Southwest

The Primary Care Shortage in the Southwest


State (1) HPSAs (2) Population (3) Shortage
AZ 217 2,848.6 560
NM 97 1,055.8 260
OK 173 1,256.9 181
TX 411 7,434.5 982
Region 898 12,595.8 1,983
U.S. 7,203 81,516.3 14,945

(1) Designated Geographic, Population Group and Facility HPSAs with a primary care shortage
(2) Population of designated HPSAs, in thousands
(3) Primary Care practitioners needed to remove HPSA Designation

Source:  Designated HPSA Quarterly Summary, 9/30/20 (HRSA)

Tuesday, December 22, 2020

Covid-19 and Medicaid Enrollment in the Great Plains Region

In an earlier commentary, we examined the impact of the Covid-19 pandemic on enrollment in Medicaid, the national medical insurance program for eligible individuals with limited income and resources. Historically, Medicaid enrollment increases during economic downturns. Weak economic conditions translate into more unemployment, more people without job-based health insurance, more people with lower household incomes, and more people who can qualify for health insurance coverage through the Medicaid program. This is in contrast to periods of expanding economic activity, when Medicaid enrollment tends to stagnate and even decline.

Like previous economic downturns, the Covid-19 induced economic contraction during 2020 has precipitated an expansion in Medicaid enrollment.  Moreover, agencies that manage the Medicaid program in each state anticipate still more growth in enrollment in coming months.  After recent years of stagnant enrollment numbers, every region of the U.S. has witnessed gains in Medicaid enrollment since the Covid-19 pandemic began. In the seven-state Great Plains region, the impact of the Covid-19 outbreak has been more severe than in other sections of the country, as Medicaid enrollment in the region grew 7.1% during the first half of 2020, much more than the 6.5% enrollment growth nationally during the same period. Here's a summary look at Medicaid enrollment growth in the Great Plains region as Covid-19 spread during the first half of 2020:

Covid-19 and Medicaid Enrollment in the Great Plains Region
Covid-19 and Medicaid Enrollment in the Great Plains Region

Medicaid Enrollment (in 000s)
State July 1, 2020 Jan 1, 2020 Growth
IA 628.2 600.1 4.7%
KS 343.0 319.2 7.5%
MN 1,097.7 1,039.4 5.6%
MO 900.4 811.6 10.9%
NE 224.2 212.2 5.7%
ND 96.2 87.7 9.8%
SD 99.9 93.5 6.8%
Region 3,389.7 3,163.7 7.1%
National 68,826.6 64,621.4 6.5%

Source: Medicaid.gov Enrollment Reports.

Monday, December 21, 2020

Radiologic Tech Pay in the Top 20 Metro Areas

According to data from the U.S. Bureau of Labor Statistics (BLS), there were about 207,000 radiologic techs (technicians and technologists) employed in the U.S. as of May 2019. This profession includes practitioners who take CAT scans and x-rays or administer nonradioactive materials for diagnostic or research purposes. It does not, however, include MRI technologists or diagnostic medical sonographers. Radiologic techs are employed mainly in hospitals and physician offices, but smaller numbers are also found employed by outpatient care centers and medical diagnostic laboratories. Radiologic techs typically earn better salaries than the average worker in most other occupations. As of May 2019, the BLS estimates that the national mean salary for radiologic techs was $63,120 per year, in comparison to the $53,490 annual mean salary for workers in all occupations in the United States. Radiologic tech pay varies widely from region-to-region. This wide variation is readily visible in BLS data from May 2019, which indicates the following about radiologic tech pay in the top 20 metro areas in the U.S.:

Metropolitan Area # Employed Annual Mean Wages
1 New York-Newark-Jersey City 12,060 $74,550
2 Los Angeles-Long Beach-Anaheim 5,860 $82,460
3 Chicago-Naperville-Elgin 5,920 $67,460
4 Dallas-Fort Worth-Arlington 3,660 $61,390
5 Houston-The Woodlands-Sugar Land 4,300 $65,760
6 Washington-Arlington-Alexandria 3,240 $74,040
7 Miami-Fort Lauderdale-Pompano Beach 4,330 $57,110
8 Philadelphia-Camden-Wilmington 4,260 $60,420
9 Atlanta-Sandy Springs-Alpharetta 3,190 $61,470
10 Phoenix-Mesa-Chandler 2,640 $66,850
11 Boston-Cambridge-Newton 3,700 $81,120
12 San Francisco-Oakland-Berkeley 2,280 $103,670
13 Riverside-San Bernardino-Ontario 1,640 $80,410
14 Detroit-Warren-Dearborn 3,010 $58,860
15 Seattle-Tacoma-Bellevue 2,120 $76,540
16 Minneapolis-St. Paul-Bloomington 2,520 $69,550
17 San Diego-Chula Vista-Carlsbad 1,820 $80,990
18 Tampa-St. Petersburg-Clearwater 1,790 $60,390
19 Denver-Aurora-Lakewood 1,860 $69,080
20 St. Louis 1,580 $53,690
National 207,360 $63,120

Source: U.S. Bureau of Labor Statistics OES. Data extracted on December 12, 2020