Indiana Primary Care Provider Workforce Study

1. Indiana Primary Care Provider Workforce Study Terrell W. Zollinger, DrPH Cynthia K. Lewis, MPH Zach Sheff, MPH Deborah I Allen, MD IU Bowen Research Center

2. IU School of Medicine Organizational Chart IU Richard M Fairbanks School of Public Health Indiana Area Health Education Network Department of Family Medicine Bowen Research Center & Indiana Center for Health Workforce Studies http://ahec.iupui.edu/indiana-center-for-health-workforce-studies-reports/workforce-indiana-overview-mulitiple-professions/

3. Who provides primary care? Physician Primary Care Providers Number/100,000 U.S. Indiana General Internal Medicine 34.5 20.8 Family Medicine 25.5 33.6 General Pediatrics 17.5 12.2 HRSA Area Resource File 2009-2010

4. All Primary Care Providers in the U.S. and Indiana - 2010

5. Distribution of the Primary Care Providers in the US, 2010 AHRQ Primary Care Workforce Facts and Stats No. 3

6. HRSA Area Resource File, 2009-2010

7. HRSA Area Resource File, 2009-2010

8. HRSA Area Resource File, 2009-2010

9. So, how are we doing? • Do we have sufficient numbers of providers to meet the need? • Are they located where needed? • What about the future? • What information is needed by programs and policy makers?

10. Impact of Affordable Care act “Success of health reform hinges on hiring 30,000 primary care doctors by 2015” http://www.washingtonpost.com/business, February 11, 2012 “...the United States will need 52,000 additional primary care physicians by 2025.” Robert Graham Center, November 2012

11. Forces Driving Supply Slow growth of health professions training programs Limited training capacity in existing institutions High cost of training – student debt to pay back Aging of the health professions workforce – 1/3 age 55+ Gender and generational differences in hours spent providing care Lower reimbursement rates for Medicare and Medicaid – no openings

12. Driving Forces: Demand Health Care Reform Providing more insurance coverage, more support for primary care services, reducing costs of care Growth of the Indiana population 18% growth from 1980 to 2010, 25,000 more each year Aging of the Indiana population Those over age 65 will double between 2000 and 2030; they make twice as many physician visits compared to those under age 65; and major and chronic illnesses are much more prevalent among those over age 65 Public expectations Baby boomers have more resources, have higher expectations, and value health care Rates of obesity and the resultant diseases, such as diabetes, are rising very fast Advances in medicine increases service demand

13. Impact of Having Health Insurance on Number of Annual Doctors Visits Robert Graham Center, 2012

14. Indiana Primary Care HPSAs

15. Indiana Counties with Greater than 100 PCPs per 100,000 Population

16. Questions to be answered… • Balance between “supply” and “demand” • Supply – What is the capacity of primary care providers in a geographical area? • Demand – What is the expected or needed number of visits by population in that same area • What is the most logical geographical unit?

17. Next steps?