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Assessing Healthcare Workforce Needs – Data and Tools for Local,
County and State Planning
3RNet Annual Conference – Wichita, Kansas
National Center for the Analysis of Healthcare Data
Ann K. Peton, MPH, Director
September, 2019
Access to current, practice location healthcare workforce data is the key to successful planning for rural, recruitment and retention
Local
County
State
Regional
Data
and
Analysis
Over ten years, the region loss 2,000 PC physicians, even though most of the MD schools expanded class size and 4 new DO schools opened
Gold areas are primary rural and areas that have gained are along the interstate or in metropolitan areas
Agenda
• Visualizing the Importance of Rural Recruitment and Retention - examples of effective recruitment programs and analysis at the local, county and state level
• Differences between NPI and NCAHD’s Enhanced State Licensure relative to Physician Analysis
• Data and Tools in support of workforce planning• Specialty Physician Supply and Demand Model
• Demonstrations of Portals
Using Data and Visualization to Better Understand Healthcare Workforce
Recruitment & Placement
Large Ohio Healthcare System wanted to become more effective in recruitment and retention but didn’t know where to start
1. Where are their employee?
2. Where is the need?
We generated Primary Care physician workforce demand analysis and compared to current supply at the zip code level.
An individual OphthalmologistContracted with us to conduct a needs assessment from a location he was considering to establish a branch office. This analysis included a distance analysis and needs assessment using our specialty physician ratios.
As a part of the specialty needs analysis, the client wanted to better understand the demand based upon his primary customer density distribution, aging population.
He utilized this information effectively to establish an office in a area of high need, which was rural Western Pennsylvania
Over the last ten years, physician and nurse practitioner education and policy stakeholders have claimed their initiatives are making the difference in meeting Ohio’s Primary Care access needs –with the visual, now (policy makers) can better now the reality of their initiatives
Over the last ten years, physician and nurse practitioner education and policy stakeholders have claimed their initiatives are making the difference in meeting Ohio’s Primary Care access needs –with the visual, now (policy makers) can better now the reality of their initiatives
In recruitment, identifying potential candidates that will successfully place in a rural/underserved or primary care practice depends greatly upon where they came from and where they are trained.
Knowing that a candidate came from a school with a mission of rural is only provides a part of their history.
You need to know what their clinical training experiences were…they will know this and your should ask for it up front.
89% of VCOM medical students come from at-risk, distressed or transitional counties in Appalachia
The proof of 12 years of meeting VCOM mission is obvious…
Differences between NPI’s Healthcare Workforce Data and NCAHD’s Enhanced State Licensure for
Annually we collect state licensure data from 50+ state board or state data centers and normalize, inventory and enhance (for data gaps, e.g. specialty information) using alumni tracking process
Using GIS, we make the practice location data spatial and use for all of our products and services
Allopathic and Osteopathic Physician data with Specialty information
Non-Physician Provider Data:
Mid-levels: Nurse Practitioners, Physician Assistant
13 Non-Physician Providers: Nurse Anesthetist, Certified Nurse Midwives, Certified Nurse Specialist, Podiatrist, Speech Language Pathologist, Audiologist, Psychologists, Optometrists, Pharmacists, Chiropractors, Physical Therapists, Dentists, Dental Hygienists
National Center for the Analysis of Healthcare Data (NCAHD)
• With HIPPA law, the federal system created to assign those business and providers a unique ID in order to track services to Medicare/Medicaid patients – never intended for use in healthcare workforce analysis
• The data is VOLUNTARILY updated by either the provider (if self-employed) or their employer or business office
• Many providers that were not assigned a ID upon graduation (i.e. over 40 years old) either do not have an individual ID or have slipped through the system
• NCAHD’s ESL represents all actively licensed providers at their practice location. Even if they are not required by the state to provide this information during licensure, we use our automated tracking process to update this information annually.
The National Provider Index (NPI) and the Difference
2019 Physician Data Comparative Analysis
StateTotal Active
Licensed NPI Total
%
Difference
#/%
Primary
Care **
Alaska - MD 1,813 940 -48% 46%
Alaska - DO 236 132 -44% 57%
Colorado - MD 13,983 7,047 -50% 38%
Colorado - DO 1,287 883 -31% 64%
Idaho - MD 2,792 1,674 -40% 42%
Idaho - DO 429 188 -56% 55%
Montana - MD 2,547 1,355 -47% 25%
Montana - DO 141 79 -44% 41%
North Dakota - MD 1,862 751 -60% 43%
North Dakota - DO 115 67 -42% 51%
Oregon - MD 10,716 5,410 -50% 37%
Oregon - DO 1,154 461 -60% 58%
South Dakota - MD 1,707 1,237 -28% 42%
South Dakota - DO 128 74 -42% 53%
Utah - MD 12,778 2,868 -78% 33%
Utah - DO 554 254 -54% 58%
Washington - MD NA 9,123 38%
Washington - DO NA 1,235 52%
Wyoming - MD 1,213 619 -49% 44%
Wyoming - DO 139 53 -62% 42%
NOSORH Region E States
2016 Physician Comparitive Analysis*
*Analysis of current, active licensed physicians based on 2016 ESL. Highlighted states
PC % based upon NPI specialty information
**Primary Care includes specialties: Family Medicine, General Practice, General
Internal Medicine, General Pediatrics and Obstetrics/Gynecology
Using the most current NPI data, we counted physicians that were classified as either MD or DO or had a physician specialty that we further validated through our automated alumni tracking process.
About 25% of NPI data does not include specialty, so we found this information for each for this comparison.
We only counted actively licensed in-state physicians found within our Enhanced State Licensure
48%
48%
42%
47%
59%
51%
29%
77%
50%
48%
50%
40%
47%
60%
50%
28%
78%
49%
44%
31%
56%
44%
42%
60%
42%
54%
62%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Alaska
Colorado
Idaho
Montana
North Dakota
Oregon
South Dakota
Utah
Wyoming
NCAHD’s Enhanced State Licensure and NPI Physician Data Differences and Their Impact Upon
Each Physician Type
DO Percent Difference
MD Percent Difference
Total Percent Difference
Data and Tools in Support of Recruitment and Retention
NCAHD Healthcare Workforce and Specialty Physician Internet Mapping Portals
• Specialty Physician Demand and Supply Tool
• Mapping analysis for 32 state’s physician demand, supply and shortage: https://portals.ncahd.org/spsdt/
• Report analysis available through VCOM’s National Center for Rural Health Works - http://ruralhealthworks.org/tools-templates/spsdt/
• National Portal provide free internet access to all workforce data by state or county aggregates with download and analysis http://www.ncahd.org/portal-development/
Kansas SDSDT county report (3 of 7 reports)
• Important to review the 5 minutes tutorial before you launch the application• Physician data represents the 2018 ESL active licensed physicians• Demand is based upon VCOM’s NCRHW physician demand model: http://ruralhealthworks.org/wp-content/uploads/2019/01/Specialty-Physician-Supply-and-Demand-Metadata.pdf
29
30
31
National Healthcare Workforce Portal
http://gis.ncahd.org
National Healthcare Workforce Portal Data
National – View individual points of all providers until region/state view then county and zip code aggregate (currently 2009 data)
Physician specialty
National Healthcare workforce trends (2008-2016)
Health Outcomes and Determinants from County Health Rankings
Demographic aggregates – 2016 Census Estimates
Healthcare facilities – hospitals, FQHC, RHC
Healthcare training sites – physician residency, medical schools and all other training sites
Federal shortage designations
Political boundaries and OMB Rural areas
Website: http://portals.ncahd.org
Service Area Workforce Assessment
How many Primary Care Workforce are within 30 minutes of a hospital?
From the drop down choose the providers that will be analyzed as to whether they practice in the service area.
To Download the data for the service area choose Identify Layer (optional)
QuestionsAnn K. Peton, MPH
Director, NCAHD and NCRHW
573-301-9654
NCAHD website: www.ncahd.org
