indiana’s health care workforce - indiana...
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An Overview Indiana’s Health Care Workforce
Jonathan Barclay, MA Zach Sheff, MPH
Indiana Medicaid Advisory Committee
Aug. 19, 2014
2
Indiana Health Workforce Reports • Methodology
- Survey offered during re-licensure (online) - Match survey response to license data - Inclusion/exclusion criteria
- Active/probationary license status - Responded to survey (& listed IN practice addr) - Reported active work status on survey
http://ahec.iupui.edu/hws
3
Indiana Health Workforce Reports
• Content of Reports - Demographic information - Professional characteristics - Education/credential background - Geographic distribution
4 Biennial Licensure Survey Datasets Reported
Year of re-licensure
Profession 1997-98 1999-2000 2001-02 2003-04 2005-06 2007-08 2009-10 2011-12 2013-14
Physicians X X X X X X X P
Registered Nurses X X X X X X X P
Physician Assistants X X X X X S
Dentists X X X S
Dental Hygienists X X X S
Pharmacists X X X S S
Mental Health1 X X X P S
Optometrists X2
Licensed Practical Nurses X3
1. Masters-prepared therapists and social workers, psychologists, psychiatrists, psychiatric nurses. 2. With IU School of Optometry 3. With Indiana Center for Nursing
Odd-year renewals
Even-year renewals
X complete P in process S to be scheduled
Indiana Healthcare Professional Development
Commission
Overall survey response rates mean 79.8% median 81.8%
Indiana State Department of Health, Indiana Professional Licensing Agency,
Indiana Center for Health Workforce Studies
5
2013 Registered Nurse Report
• Total licenses: 99,580 • Total online renewals: 89,223 (89.6%) • Total survey responders: 80,934 • Total active in Indiana: 52,111
-Response Rate: 90.7%
6
2013 Registered Nurse Report
2013 RNs 54.5% Staff Nurses 60.1% Hospital based* 74.0% Work 36+ hours per week 3,131 Advanced Practice Nurses 945 Nursing Faculty *Includes short term, long term, psychiatric, non-psychiatric, federal, and non-federal hospitals
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
1995 2000 2005 2010 2015 2020
Perc
ent o
f RN
s Inc
lude
d in
Ana
lysis
Year
Diploma Associate Degree
Bachelor's Degree Master's Degree
Doctorate Linear (Doctorate)
7
2013 Registered Nurse Report
Rate per 100,000
Population
Indiana FTEs* 741
Indiana† 901
United States† 853
*Source: 2013 registered nurse IPLA licensure data and survey data gathered during re-licensure †Source: Area Health Resources Files (AHRF). 2012-2013. US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Rockville, MD.
8
2012 Dentist Report
• Total licenses: 3,748 • Total online renewals: 3,356 (89.5%) • Total survey responders: 3,025 • Total active in Indiana: 2,314
-Response Rate: 90.1%
9
2012 Dentist Report 2010: 2,693 active IN dentists 2012: 2,314 active IN dentists 2012 Dentists 62.3% Work 30-39 hrs/wk 78.9% In general dentistry 37.8% Over 55 years old
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Under 35 35 - 54 55 - 64 65 and older
Female Male
10 Rural Counties Report Chronic Barriers to Access to Oral Health Services
Rate per 100,000
Population
Indiana FTEs* 38
Indiana† 24
United States† 30
*Source: 2012 dentist IPLA licensure data and survey data gathered during re-licensure †Source: Area Health Resources Files (AHRF). 2012-2013. US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Rockville, MD.
11 HRSA Shortage Designations can increase access to federal workforce resources
Source: Indiana Primary Health Care Association; http://www.indianapca.org/?page=20
12
2012 Mental Health Report Professions included in report: • Clinical social workers, social workers, marriage
and family therapists, mental health counselors (Licensed Mental Health Professionals)
• Psychologists • Psychiatrists • Psychiatric/Mental Health Advanced Practice
Nurses
13
2012 Mental Health Report
LMHPs Psychologists Psychiatrists PAPNs
Total licenses 8,803 1,706 - -
Total online renewals 5,159 (58.6%) 1,497 (87.7%) - -
Total survey responders 5,092 1,492 661 129
Total active in Indiana 3,687 1,064 356 76
Response Rate 98.7% 99.7% 74.7% -
14
Psychiatrist Shortage Worsens
Profession Mean Age Plan to retire
within 10 years
LMHPs 48.9 26.3%
Psychologists 52.2 34.2%
Psychiatrists 55 n/a
PAPNs n/a 43.4%
74 Mental Health Professional FTEs per 100,000 population
0
1000
2000
3000
4000
5000
6000
2002 2004 2006 2008 2010 2012 2014 2016
Men
tal H
ealth
Pro
fess
iona
ls
Active Indiana LMHPs Active Indiana Psychologists
Active Indiana Psychiatrists Active Indiana PAPNs
15
Rural Communities Face Urgent Behavioral Health Provider Shortages • 5 counties with no LMHPs • 27 counties with no
psychologists • 43 counties with no
psychiatrists
• 4 counties with no mental health professionals
16
2014 Mental Health HPSA Map
Source: Indiana Primary Health Care Association; http://www.indianapca.org/?page=20
17
2013 Physician Data • Total licenses: 25,800 • Total online renewals: 23,742 (92.0%) • Total survey responders: 17,735 • Total active in Indiana: 9,461
-Response Rate: 74.7%
18
Primary Care Physician Workforce Growth is Anemic
0
1000
2000
3000
4000
5000
6000
7000
8000
2002 2004 2006 2008 2010 2012 2014
Act
ive
Indi
ana
Phys
icia
ns
Primary Care Non-Primary Care
Rate per 100,000
Population
Indiana FTEs* 129
Indiana† 170
United States† 198
*Source: 2013 physician IPLA licensure data and survey data gathered during re-licensure †Source: Area Health Resources Files (AHRF). 2012-2013. US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Rockville, MD.
20
Need for Primary Care Access is a Function of Provider Supply and Population Health
Source: Indiana Primary Health Care Association; http://www.indianapca.org/?page=20
22
2013 Percent of Patients Paying with Indiana Medicaid
0
5
10
15
20
25
30
I do notacceptIndiana
Medicaid
IndianaMedicaidaccountsfor 0% - 5%
of mypractice
IndianaMedicaidaccounts
for 6% - 10%of my
practice
IndianaMedicaidaccountsfor 11% -
20% of mypractice
IndianaMedicaidaccountsfor 21% -
30% of mypractice
IndianaMedicaidaccountsfor 31% -
50% of mypractice
IndianaMedicaidaccounts
for greaterthan 50% ofmy practice
Phys
icia
n FT
Es p
er 1
00,0
00 P
opul
atio
n
Urban
Rural
23
Questions?
Health Workforce Studies Program Indiana AHEC Network Department of Family Medicine Indiana University School of Medicine
Jonathan Barclay, MA Associate Director (317) 278-8893 jbarclay@iupui.edu
Zach Sheff, MPH Project Coordinator (317) 278-9284 zsheff@indiana.edu
Hannah Maxey, PhD Incoming Director hlmaxey@iupui.edu
http://ahec.iupui.edu/hws
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