Growing, aging population straining primary care, report shows
- Primary care is the bedrock of the healthcare system, yet 13% of Americans reside in a county with a primary care physician shortage, UnitedHealth Group reports. Rural residents are five times as likely as urban residents to live in a county with a primary care shortfall, yet the numbers of urban and rural residents who lack access to primary care is similar — 21 million versus 23 million.
- The problem could get worse before it gets better. Last year, just one in six medical school graduates chose a primary care residency program.
- At the same time, two of the 10 most lucrative fields of study for college students are health and medical preparatory programs (No. 4) and pharmacy, pharmaceutical sciences and administration (No. 6), a new Bankrate survey shows.
Driving the primary care shortage is both a growing and aging population. According to giant insurer's report, the U.S. population is projected to reach 355 million by 2030, up 8% from the current 328 million. The number of Americans 65 and older will increase 38% and those 75 and older, 55%. A third of those 65 and older, 59 million, will have at least one chronic disease.
Those numbers seem daunting at first glance, but an upswing in nurse practitioners and other advanced health professionals could ease the shortage. The Bureau of Labor Statistics shows the number of education and health services jobs grew 1.9% to 23.7 million over the past year.
About 16,000 NPs graduate from primary care programs each year, more than three times the rate of physicians, UnitedHealth notes. At that rate, there should be nearly twice as many NPs in primary care by 2025 as currently exist. In addition to being more likely to choose primary care, NPs are more likely to practice in rural and underserved communities.
The numbers of physician assistants and certified nurse midwives are also on the rise and could help bridge the gap.
Leveraging different delivery models such as urgent care and retail clinics and allowing NPs and physician assistants to practice at the top of their license could also increase access to primary care, according to the analysis. Currently, 22 states give NPs full authority to practice primary care independently, 16 states allow limited practice authority and 12 require onsite supervision by a physician.
"Making better use of the workforce we have through innovations in service delivery and modifications in scope of practice laws/regulations can help increase access, improve quality and constrain the growth in health care costs," Edward Salsberg, director of health workforce studies at George Washington University's Health Workforce Institute, previously told Healthcare Dive.
- UnitedHealth Group Addressing the Nation’s Primary Care Shortage: Advanced Practice Clinicians and Innovative Care Delivery Models
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