Seven million Americans live in areas where demand for primary care may exceed supply by more than 10 percent

Health Affairs

Volumn 32, Issue 3, 2013, Pages 614-621

  Huang, Elbert S ^a   Finegold, Kenneth ^b  

^a UNIVERSITY OF CHICAGO   (United States)

^b U S DEPARTMENT OF HEALTH AND HUMAN SERVICES   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE DELIVERY; HEALTH CARE NEED; HEALTH CARE POLICY; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HUMAN; PRIMARY MEDICAL CARE; UNITED STATES;

CAREER CHOICE; FORECASTING; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; MEDICALLY UNDERSERVED AREA; PATIENT PROTECTION AND AFFORDABLE CARE ACT; PHYSICIANS, PRIMARY CARE; PRIMARY HEALTH CARE; UNITED STATES;

EID: 84875043279     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.0913     Document Type: Article

References (26)

1. Scheffler RM, Weisfeld N, Ruby G, Estes EH. A manpower policy for primary healthcare. N Engl J Med. 1978;298:1058-62.
2. Council on Graduate Medical Education. Sixteenth report: physician workforce policy guidelines for the United States, 2000-2020 [Internet]. Rockville (MD): COGME; 2005 Jan [cited 2013 Feb 11]. Available from: http://www.hrsa .gov/advisorycommittees/bhpradvisory/cogme/Reports/sixteenthreport.pdf
3. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502.
4. Ku L, Jones E, Finnegan B, Shin P, Rosenbaum S (George Washington University). How is the primary care safety net faring in Massachusetts? Community health centers in the midst of health reform [Internet]. Washington (DC): Kaiser Commission on Medicaid and the Uninsured; 2009 Mar [cited 2013 Jan 25]. Available from: http://www.kff.org/healthreform/upload/7878.pdf
5. Staiger DO, Auerbach DI, Buerhaus PI. Health care reform and the health care workforce-the Massachusetts experience. N Engl J Med. 2011; 365(12):e24.
6. Hofer AN, Abraham JM, Moscovice I. Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization. Milbank Q. 2011;89(1):69-89.
7. To calculate the national percentage increase in demand for primary care physicians and providers (including nurse practitioners and physician assistants), we used national estimates of the number of primary care physicians and providers based on discussions conducted within the Department of Health and Human Services between January and May 2011
8. Ku L, Jones K, Shin P, Bruen B, Hayes K. The states' next challenge-securing primary care for expanded Medicaid populations. N Engl J Med. 2011;364(6):493-5.
9. Through the Physician Bonus Payment Program, Medicare provides a 10 percent bonus for services provided in Health Professional Shortage Areas
10. Goodman DC, Mick SS, Bott D, Stukel T, Chang CH, Marth N, et al. Primary care service areas: a new tool for the evaluation of primary care services. Health Serv Res. 2003;38(1 Pt 1):287-309.
11. O'Hara B, Bauder M. Small-domain estimation of health insurance coverage. Chapter 13 in: National Research Council. Databases for estimating health insurance coverage for children. Washington (DC): National Academies Press; 2010. p. 165-82.
12. To access the Appendix, click on the Appendix link in the box to the right of the article online
13. Congressional Budget Office. Cost estimate for the amendment in the nature of a substitute for H.R. 4872, incorporating a proposed manager's amendment made public on March 20, 2010. Washington (DC): CBO; 2010 Mar 10. To calculate the percentage insured under the Affordable Care Act, we usednumbers from this forecast for 2016, when the law appeared to have a steady-state effect. In that year fiftytwo million people are forecast to be uninsured had the Affordable Care Act not been passed. With the law, thirty million of those fifty-two million are forecast to be insured.
14. Ezzati-Rice TM, Rohde F. Variation in ambulatory health care visits and visits for general checkup by demographic characteristics and insurance status, U.S. civilian noninstitutionalized population ages 18-64, 2005 [Internet]. Rockville (MD): Agency for Healthcare Research and Quality; 2008 Mar [cited 2013 Jan 25]. (Statistical Brief No. 201). Available from: http://www.meps.ahrq.gov/mepsweb/data_files/publications/st201/stat201.pdf
15. Our analysis does not account for the differential health status of the uninsured. Analyses from the Medical Expenditure Panel Survey have suggested that after age is controlled for, the uninsured are sicker than the insured. Roehrig C. Health status of the uninsured and implications for physician requirements under expanded coverage. Oral presentation at: AcademyHealth Annual Research Meeting; 2011 Jun 13; Seattle, WA.
16. Hsiao CJ, Cherry DK, Beatty PC, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2007 summary. Natl Health Stat Report. 2010;(27):1-32.
17. Kletke P. Physician workforce data: when the best is not good enough. Health Serv Res. 2004;39(5):1251-5.
18. Shea JA, Kletke PR, Wozniak GD, Polsky D, Escarce JJ. Self-reported physician specialties and the primary care content of medical practice. Med Care. 1999;37(4):333-8.
19. Chang CH, Stukel TA. Primary care physician workforce and Medicare beneficiaries' health outcomes. JAMA. 2011;305(20):2096-105.
20. Nyweide DJ, Anthony DL, Chang C-H, Goodman D. Seniors' perceptions of health care not closely associated with physician supply. Health Aff (Millwood). 2011; 30(2):219-27.
21. Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA. 2009;301(19):2038-40.
22. Green LV, Savin S, Lu Y. Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication. Health Aff (Millwood). 2013;32(1):11-9.
23. National Institute for Health Care Management Foundation. Understanding the uninsured: tailoring policy solutions for different subpopulations [Internet]. Washington (DC): NIHCM Foundation; 2008 Apr [cited 2013 Jan 25]. (NIHCM Foundation Issue Brief). Available from: http://www.nihcm.org/pdf/NIHCMUninsured-Final.pdf
24. National Federation of Independent Business v. Sebelius, 567 U.S., 2012 WL 2427810 (2012 Jun 28).
25. Goodman DC. Twenty-year trends in regional variations in the U.S. physician workforce. Health Aff (Millwood). 2004;23:var-90-7. DOI: 10.1377/hlthaff.var.90.
26. Shipman SA, Lan J, Chang CH, Goodman DC. Geographic maldistribution of primary care for children. Pediatrics. 2011;127(1):19-27.