{"id":2373,"date":"2024-02-01T14:52:26","date_gmt":"2024-02-01T14:52:26","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=2373"},"modified":"2024-02-01T14:52:27","modified_gmt":"2024-02-01T14:52:27","slug":"is-the-nations-primary-care-shortage-as-bad-as-federal-data-suggest","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=2373","title":{"rendered":"Is the Nation\u2019s Primary Care Shortage as Bad as Federal Data Suggest?"},"content":{"rendered":"
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Federal policymakers have been trying for a long time to lure more primary care providers to understaffed\u00a0areas<\/u><\/a>. The Biden administration\u00a0boosted funding<\/u><\/a>\u00a0in 2022 to address shortages and Sen.\u00a0Bernie Sanders<\/strong>\u00a0(I-Vt.)\u00a0pushed sweeping primary care legislation<\/u><\/a>\u00a0in 2023.<\/p>\n

But when KFF Health News set out last year to map where the primary care workforce shortages really are \u2014 and where they aren\u2019t \u2014 we encountered spotty data and a whole lot of people telling us the absence of better information makes it hard to know which policies are working.\u00a0Turns out, consistent national data is a pipe dream.<\/strong><\/p>\n

We analyzed the public data that doesexist: the federal government\u2019s\u00a0official list<\/u><\/a>\u00a0of primary care health professional \u201cshortage areas,\u201d created to help funnel providers where they\u2019re most needed.\u00a0We found that more than 180 areas have been stuck on the primary care shortage list for at least 40 years.\u00a0<\/strong><\/p>\n

Here\u2019s a map:<\/p>\n

\u201cThere\u2019s no government organization that\u2019s tracking: Who trained in what, where, and where are they now, and what are they practicing?\u201d said\u00a0Alison Huffstetler<\/strong>, medical director of the\u00a0Robert Graham Center<\/strong>, a think tank in Washington that focuses on primary care. \u201cIf we don\u2019t know who is doing what kind of care \u2014 and where \u2014 then there is no way for us to equitably manage the patient-to-clinician ratio across every state.\u201d<\/p>\n

Shortage areas get a bunch of carrots to lure medical providers, including federal student loan repayments,\u00a0bonus Medicare payments<\/u><\/a>\u00a0and expedited visas for foreign clinicians.<\/p>\n

The fact that areas have languished on the shortage list is not because of a dwindling supply of doctors. According to the\u00a0Federation of State Medical Boards<\/strong>, the number of licensed U.S. physicians more than doubled from 1990 to 2022, to over 1 million, outpacing overall population growth.<\/p>\n

A\u00a0Health Affairs<\/u><\/strong>\u00a0study published in November shows<\/u><\/a>\u00a0the federal designations, which help allocate an estimated\u00a0$1 billion\u00a0<\/strong>in annual funding through at least 20 federal programs aimed at boosting primary care capacity, haven\u2019t meaningfully nudged up the provider-to-population ratios.<\/p>\n

One possible explanation for the persistence of shortage areas is that the incentives are too small or too fleeting, said\u00a0Justin Markowski<\/u><\/strong><\/a>, a\u00a0Yale School of Public Health<\/strong>\u00a0doctoral student, who co-wrote the Health Affairs study.<\/p>\n

But another crucial issue is how shortages are measured.<\/p>\n

It\u2019s up to state health authorities to\u00a0identify populations and locations<\/u><\/a>\u00a0that might qualify as shortage areas and\u00a0submit them<\/u><\/a>\u00a0to the\u00a0Health Resources and Services Administration<\/strong>, which\u00a0then scores<\/u><\/a>the extent of any shortages. The funding and staffing for those state offices vary, creating an uneven foundation.<\/p>\n

Further, the main metric for identifying shortage areas, the doctor-to-population ratio, has a glaring weakness. It considers only physicians, not the myriad other health-care professionals, like physician assistants and nurse practitioners, who\u00a0provide<\/u><\/a>\u00a0much of our nation\u2019s primary care.<\/p>\n

Take Costilla County in southern Colorado<\/strong>. It was deemed a primary care shortage area in 1978 and hasn\u2019t left the list since. It\u2019s true the area could use more clinicians. But it\u2019s also true that federal data has overlooked providers who\u00a0are<\/em>\u00a0there, like the nurse practitioner who has been driving in from the nearest city once a week to see patients, or the physician assistant who just relocated from Texas to fill the gap more permanently.<\/p>\n

Since 1998, federal officials have made three attempts to update the 1970s-era rules that define shortage areas. Most recently, the authors of the Affordable Care Act created a committee of experts to figure it out.<\/p>\n

When that failed, Colorado came up with its\u00a0own health professional shortage area designations<\/u><\/a>, which factor in nurse practitioners and physician assistants.<\/p>\n

\u201cIt\u2019s so important for the nation to target its resources to the highest-need communities,\u201d said\u00a0Ed Salsberg<\/u><\/strong><\/a>, who was the lead federal government representative on the ACA-created committee and who headed HRSA\u2019s\u00a0National Center for Health Workforce Analysis<\/strong>. \u201cIt\u2019s time again to try one more time to develop an improved methodology.\u201d<\/p>\n

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This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org<\/a>.<\/em><\/p>\n

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