Primary Care Access and Supply

1. Primary Care Access and Supply Stacey EcclestonDivision of Health Care Finance and Policy June 29, 2011

2. A robust primary care workforce is important to improving health outcomes Evidence from the literature: • Research shows that there is a strong relationship between the supply of primary care physicians (PCPs) and overall population health. • Studies have shown that states with higher ratios of primary care physicians to population have lower rates of all causes of mortality such as mortality from heart disease, cancer, or stroke; infant mortality; and low birth weight. • Evidence also shows that a greater emphasis on primary care can be expected to reduce the cost of care, improve health through access to more appropriate services, and reduce inequalities in the population’s health. • The primary care physician plays a central role in coordinating patient care.

3. Data sources Data for this presentation are from three main sources: • Physician workforce survey data from the Massachusetts Medical Society (MMS); • State physician workforce data from the Association of American Medical Colleges’ (AAMC) Center for Workforce Studies; and • Massachusetts Household Insurance Survey (MHIS) data from the Division of Health Care Finance and Policy (DHCFP). Where necessary, data has been supplemented with reviews of articles from professional journals and other sources.

4. Massachusetts had more active physicians per population in 2009 than the rest of nation Source: Association of American Medical Colleges

5. But the PCP workforce as a proportion of total physician workforce was lower in Massachusetts than rest of nation Source: Association of American Medical Colleges

6. Only about half of PCP physician offices reported that they accepted new patients in 2010 Source: Massachusetts Medical Society

7. Percent of primary care physician offices accepting new patients has been declining since 2005 Source: Massachusetts Medical Society

8. As of June 2011, nearly 14% of Massachusetts residents live in HRSA-defined primary care shortage area Source: US Health Resources and Services Administration, Bureau of Primary Health Care Population data are from the 2010 United States Census

9. More than one in five Massachusetts residents report difficulty getting care in 2010 Source: Massachusetts Division of Health Care Finance and Policy

10. New patients in the Boston, southeast, and western regions report having more difficulty obtaining health care Source: Massachusetts Division of Health Care Finance and Policy

11. Getting a health care appointment when needed reported to be more difficult for residents of Boston and Western MA Source: Massachusetts Division of Health Care Finance and Policy

12. More than 3 in 10 Massachusetts residents with state public health insurance coverage reported some access difficulty Percentage of Massachusetts Residents with Full-Year Insurance Coverage in 2008 and 2009 who Report Difficulty Getting Care, By Insurance Type Source: Massachusetts Division of Health Care Finance and Policy

13. For more information: www.mass.gov/dhcfp/costtrends