Measuring the potential impact of health reform on the primary care workforce

The Affordable Care Act (ACA) is expected to substantially raise the numbers of Americans with health insurance across the country. Primary care provider (PCP) shortages are predicted to intensify as a result of the national health reform. To measure the ACA's potential impact on the primary care workforce in Rhode Island, a situational analysis was completed. This presentation will discuss current statewide workforce initiatives and the results of the analysis. Our research questions were: How many PCPs are active in Rhode Island? How many are needed? What is the potential impact of health reform on the primary care workforce? Data were analyzed from the Area Resource File 2011-2012. PCP-per-population ratios were calculated. Benchmarks were selected: 1) threshold for HRSA Health Professional Shortage Area and 2) optimal number of PCPs recommended by the Council on Graduate Medical Education (COGME). The number of uninsured residents who are predicted to gain coverage was also identified. Current PCP ratios were compared to the PCP ratios needed for the expected newly-insured residents. Statewide, Rhode Island has about 111 PCPs per 100,000 persons, ranging by county from 89 to 174 PCPs-per-person. Approximately 58,000 residents are expected to enroll in health insurance under ACA. The findings suggests Rhode Island does currently have an adequate number of PCPs statewide and in each county to accommodate the expected additions of insured residents. However, there are limitations to this analysis. PCP accessibility among medically underserved areas and populations, medical student specialty selection, and physician retirement rate, are issues that should be considered in the assessment of the primary care workforce.