Indiana’s Health Care Workforce - Indiana Universityahec.iupui.edu/files/9214/0855/3801/Medicaid_Adv_Comm_Aug_2014_2.pdfIndiana’s Health Care Workforce . ... Indiana State Department

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 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


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


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


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


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.

19

Primary Care Supply is Important in All Counties

20

Need for Primary Care Access is a Function of Provider Supply and Population Health


21

Rural Docs Respond to Need: Physicians Offering a Sliding Fee Scale

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


30% of mypractice


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 [email protected]

Zach Sheff, MPH Project Coordinator (317) 278-9284 [email protected]

Hannah Maxey, PhD Incoming Director [email protected]

http://ahec.iupui.edu/hws

Documents

Indiana’s Health Care Workforce - Indiana Universityahec.iupui.edu/files/9214/0855/3801/Medicaid_Adv_Comm_Aug_2014_2.pdfIndiana’s Health Care Workforce . ... Indiana State Department