ncahd 2016 products services
TRANSCRIPT
National Center for the Analysis of Healthcare Data
Ann K. Peton, MPHDirector
National Center for the Analysis of Healthcare Data (NCAHD)
2
Established in May 2007 Founding Project – AMA/AOA Scope of Practice
Partnership Established unique methodology to create national
healthcare workforce datasets from state licensure 2008-2010 – major project with Health Resources
Services Administration to provide national data for the Area Resource File
2010 Established our own national advisory board made up on 15 nationally recognized healthcare workforce leaders
National Center for the Analysis of Healthcare Data (NCAHD)
Mission and ObjectivesThe Center’s focus is to provide data mapping
and spatial analysis of either your data and/or our data warehouse of the nation’s most complete collection of physician and non-physician data, along with other demographic, socio-economic, and political data in support of your advocacy, medical education planning/expansion, research, and other healthcare workforce planning
National Center for the Analysis of Healthcare Data (NCAHD)
Allopathic and Osteopathic Physician data with Specialty information
Non-Physician Provider Data:Mid-levels: Nurse Practitioners, Physician Assistant13 Non-Physician Providers: Nurse Anesthetist,
Certified Nurse Midwives, Certified Nurse Specialist, Podiatrist, Speech Language Pathologist, Audiologist, Psychologists, Optometrists, Pharmacists, Chiropractors, Physical Therapists, Dentists, Dental Hygienists
National Center for the Analysis of Healthcare Data (NCAHD)
Past/Current Clients (over 200 projects and/or clients in the last eight years)
• National physicians and non-physician associations (e.g. American Osteopathic Association, American Medical Association, Physician Assistant Education Association, etc.)
• Colleges of Medicine (KCUMB-COM, AT Still University, Vanderbilt, University of Chicago, etc.) and Area Health Education Associations (state and regional programs)
• Healthcare research institutes and rural health associations (e.g. NRHA, Robert Graham Center, etc.)
• Hospital Associations, state workforce boards, state provider associations, state agencies (e.g.Tennessee Hospital Association/ Rural Partnership, West Virginia Rural Health Association)
National Center for the Analysis of Healthcare Data (NCAHD)
• Data Research – aside from our enhanced state licensure (ESL), we find and process many other state and national demographic, socio-economic, health indicators, etc. to support research, proposal development, planning, etc.
• Mapping and Spatial Analysis• Alumni Tracking – validate school’s existing alumni and/or find missing
alumni; perform analysis on specialty, proximity to rural and underserved, etc.
• Training on GIS/mapping• Healthcare workforce economic impact analysis – for medical schools
and entire primary care workforce• Time Series mapping/data subscription service (Future)• Internet Mapping Portal Development – current projects with
Tennessee, West Virginia, Arkansas and New York and the American Osteopathic Association
NCAHD’s Products and Services
State Comparative Provider Analysis of Rural to Urban Practice PatternsPhysicians, Nurse Practitioner and Physician Assistants 2008-2014
State Total % Rural % Urban Total % Rural % Urban Total % Rural % Urban Total Rural Urban Total Rural Urban Total Rural Urban Total Rural UrbanOverall Change Rural Urban
Overall Change Rural Urban
Alabama 10,823 5% 95% 554 7% 93% 2,581 4% 96% 8% 5% 95% 74% 7% 93% 64% 4% 96% 6% 10% 1% 71% 133% 59% 61% 55% 56%Alaska 1,870 23% 77% 443 30% 70% 582 23% 77% 14% 29% 71% 25% 31% 69% 17% 39% 61% 5% 23% 3% 15% 15% 15% 8% 20% 5%Arizona 15,045 3% 97% 1,854 3% 97% 3,274 3% 97% 7% -3% 103% 27% -10% 110% 16% -12% 112% 4% 64% 0% 22% 7% 22% 12% 18% 10%Arkansas 6,146 7% 93% 247 9% 91% 1,519 8% 92% 7% 7% 93% 90% 9% 91% 62% 8% 92% 4% 13% -1% 86% 56% 82% 59% 46% 58%California 114,708 1% 99% 8,944 1% 99% 18,294 2% 98% 17% 1% 99% 28% 1% 99% 28% 2% 98% 15% 24% 15% 26% 33% 26% 26% 28% 25%Colorado 14,469 8% 92% 2,088 6% 94% 2,867 8% 92% 10% 6% 94% 37% 2% 98% 6% -6% 106% 3% 26% 0% 28% 22% 27% -1% 8% -2%Connecticut 12,694 1% 99% 1,707 1% 99% 3,579 0% 100% 5% 1% 99% 25% 1% 99% 30% 0% 100% 5% 40% 5% 24% 27% 24% 29% 63% 29%Delaware 2,455 2% 98% 268 2% 98% 598 2% 98% 6% 2% 98% 35% 2% 98% 60% 2% 98% 3% 138% -1% 32% 481% 26% 57% 16% 56%Florida 50,348 4% 96% 6,488 1% 100% 14,289 1% 99% 9% -3% 103% 34% -2% 102% 34% -2% 102% 7% 29% 6% 7% 29% 6% 46% 24% 46%Georgia 23,213 2% 98% 3,880 2% 98% 4,448 4% 96% 11% -19% 119% 38% -5% 105% 38% -18% 118% 8% 6% 4% 35% 23% 30% 17% 11% 15%Idaho 3,132 9% 91% 570 8% 92% 650 9% 91% 4% 4% 96% 6% -41% 141% 43% -8% 108% -4% 48% -13% -2% 11% -8% 33% 15% 29%Illinois 37,706 2% 98% 2,760 2% 98% 8,377 5% 95% 26% 2% 98% 34% 2% 98% 47% 5% 95% 25% 29% 24% 33% 13% 34% 46% 41% 45%Indiana 15,485 3% 97% 966 4% 96% 4,035 3% 97% 5% 3% 97% 59% 4% 96% 53% 3% 97% 4% 13% 1% 57% 14% 57% 51% 62% 49%Iowa 7,249 24% 76% 809 24% 76% 1,143 24% 76% 7% -1% 101% 17% -9% 109% 12% -25% 125% 3% 16% -5% 13% 11% 12% 7% 6% 6%Kansas 6,015 6% 94% 903 7% 93% 2,220 17% 83% -2% 6% 94% 23% 7% 93% 57% 17% 83% -4% -3% -6% 21% 22% 21% 55% 37% 57%Kentucy 11,114 11% 89% 1,015 13% 87% 3,495 13% 87% 10% 11% 89% 30% 13% 87% 69% 13% 87% 9% 38% -1% 28% 30% 21% 67% 72% 61%Louisiana 11,395 3% 97% 746 3% 97% 2,973 3% 97% 6% 3% 97% 61% 3% 97% 80% 3% 97% 3% 24% -1% 57% 53% 53% 76% 96% 71%Maine 4,320 24% 76% 524 26% 74% 1,041 24% 76% 8% -10% 110% 183% 21% 79% 15% 14% 86% 7% 7% 5% 178% 127% 204% 13% 20% 9%Maryland 21,382 1% 99% 2,268 1% 99% 2,886 1% 99% 8% -1% 101% 22% -1% 101% 10% -5% 105% 3% 56% 2% 17% 29% 16% 5% 22% 5%Massachusetts 27,276 1% 99% 2,417 1% 99% 7,078 1% 99% 1% 1% 99% 42% 1% 99% 31% 1% 99% 0% 63% 0% 41% 32% 41% 30% 19% 30%Michigan 29,826 4% 96% 4,235 5% 95% 4,899 6% 94% 4% 4% 96% 34% 5% 95% 46% 6% 94% 5% 0% 4% 35% 9% 36% 47% 48% 46%Minnesota 14,683 10% 90% 1,447 10% 90% 2,620 10% 90% 8% 1% 99% 31% 2% 98% 27% 7% 93% 4% 10% 2% 26% 16% 26% 23% 27% 21%Mississippi 6,161 9% 91% 114 10% 90% 2,502 5% 95% 14% 9% 91% 68% 10% 90% 74% 5% 95% 12% 39% 1% 65% 108% 47% 72% 75% 64%Missouri 15,075 5% 95% 629 6% 94% 3,980 6% 94% -3% 5% 95% 17% 6% 94% 54% 6% 94% -4% 2% -7% 15% -3% 14% 52% 44% 52%Montana 2,675 33% 67% 449 29% 71% 471 33% 67% 14% 21% 79% 38% 21% 79% -1% -1% -1% 7% 13% 4% 30% 25% 31% -3% 0% -5%Nebraska 4,374 13% 87% 874 21% 79% 992 13% 87% 5% -8% 108% 32% 21% 79% 34% 10% 90% -1% 1% -4% 25% 41% 20% 27% 33% 24%Nevada 5,379 1% 99% 501 2% 98% 722 1% 99% 8% -2% 102% 14% -3% 103% 29% -3% 103% -1% 85% -3% 5% 73% 3% 18% 15% 16%New Hampshire 4,089 14% 86% 535 8% 92% 275 14% 86% 7% -2% 102% 22% -2% 102% 80% 11% 89% 6% -9% 9% 21% -12% 25% 78% 44% 85%New Mexico 4,876 8% 92% 550 8% 92% 1,005 8% 92% 6% 2% 98% 19% 17% 83% 30% 10% 90% -1% -4% -1% 11% 45% 9% 21% 32% 20%New York 70,916 2% 98% 9,980 2% 98% 12,463 4% 96% 6% 2% 98% 23% 2% 98% 1% 4% 96% 5% -11% 5% 22% 26% 21% 0% 6% -1%North Carolina 22,704 3% 97% 4,886 5% 95% 5,093 5% 95% 3% 3% 97% 42% 5% 95% 54% 5% 95% 0% -7% -2% 37% 30% 35% 49% 46% 48%North Dakota 1,626 28% 72% 243 29% 71% 443 28% 72% 8% 1% 99% 16% 9% 91% 34% 18% 82% -2% 10% -10% 6% 14% 1% 23% 31% 17%Ohio 32,066 2% 98% 2,335 2% 98% 6,950 4% 96% 7% 2% 98% 35% 2% 98% 81% 4% 96% 7% 9% 6% 35% 43% 34% 81% 102% 79%Oklahoma 8,664 6% 94% 957 15% 85% 892 16% 84% 8% -11% 111% 39% 3% 97% 346% 3% 97% 5% 332% -18% 36% 32% 34% 15% 26% 12%Oregon 12,982 5% 95% 1,232 4% 96% 1,657 5% 95% 17% 3% 97% 68% 1% 99% -3% 79% 21% 12% 54% 9% 60% 43% 60% -7% -11% -7%Pennsylvania 44,127 2% 98% 6,310 2% 98% 8,053 5% 95% 14% 2% 98% 58% 2% 98% 44% 5% 95% 13% 28% 11% 57% 104% 54% 43% 48% 42%South Carolina 11,304 2% 98% 1,186 4% 96% 2,385 4% 96% 18% 2% 98% 97% 4% 96% 51% 4% 96% 14% 27% 10% 91% 174% 84% 46% 30% 44%South Dakota 1,852 14% 86% 453 15% 85% 548 23% 77% 8% 56% 44% 13% -64% 164% 3% 19% 81% 5% 245% -22% 0% -37% 10% 56% 55% 54%Tennessee 17,091 4% 96% 1,434 5% 95% 6,620 6% 94% 7% 4% 96% 46% 5% 95% 47% 6% 94% 5% 10% 1% 42% 41% 39% 44% 42% 41%Texas 57,403 8% 92% 6,568 3% 97% 11,660 4% 97% 18% 37% 63% 48% -1% 101% 48% 1% 99% 14% 370% 5% 43% 17% 43% 58% 46% 57%Utah 6,726 2% 98% 1,080 4% 96% 1,601 5% 95% 8% 2% 98% 44% 4% 96% 41% 5% 95% 3% -12% 2% 38% 14% 39% 35% -37% 39%Vermont 2,517 29% 71% 293 33% 67% 458 41% 59% 25% 29% 71% 28% 33% 67% 60% 41% 59% 23% 17% 22% 27% 31% 21% 58% 54% 58%Virginia 22,199 4% 96% 2,307 6% 94% 4,933 4% 96% 9% 4% 96% 49% 6% 94% 43% 4% 96% 6% 5% 3% 45% 12% 43% 39% 46% 37%Washington 1,218 18% 82% 218 31% 69% 214 18% 82% 15% 20% 80% 35% 16% 84% 3% -14% 114% 3% 6% 1% 22% 9% 29% -7% -8% -8%West Virginia 4,853 11% 89% 707 16% 84% 1,100 12% 88% 4% 11% 89% 45% 16% 84% 75% 12% 88% 3% 19% -8% 43% 34% 36% 73% 81% 63%Wisconsin 13,577 7% 93% 2,050 9% 91% 3,692 12% 88% -15% 7% 93% 18% 9% 91% 42% 12% 88% -16% -18% -18% 18% 9% 17% 40% 39% 39%Wyoming 22,203 5% 95% 2,134 4% 96% 4,051 5% 95% 18% 0% 100% 10% -19% 119% 32% 2% 98% 10% 31% 8% 2% -2% 2% 23% 49% 21%
2015 Physicians (MDDO)
% Change in # of Physicians
% Overall Change in Physicians per
100,000
% Overall Change in Nurse
Practitioners per 100,000
2015 Physician Assistants
2015 Nurse Practitioners
% Change in # of Physician Assistants
% Change in # of Nurse
Practitioners
% Overall Change in Physician
Assistants per 100,000
Per 100,000
Population Average Ratio
Per 100,000
Population Average Ratio
Per 100,000
Population Average Ratio
Family Medicine 28.08 1:3,561 35.54 1:2,814 26.66 1:3,750Internal Medicine 22.86 1:4,374 13.03 1:7,672 24.73 1:4,043Pediatrics 12.83 1:7,796 9.63 1:10,389 13.44 1:7,443
Allergy & Immunology 1.17 1:85,737 0.54 1:186,207 1.29 1:77,746Cardiology 5.51 1:18,140 2.96 1:33,833 6.00 1:16,667Dermatology 2.80 1:35,762 1.17 1:85,462 3.11 1:32,196Endocrinology, Diabetes, and Metabolism 1.05 1:95,096 0.36 1:280,334 1.18 1:84,464Gastroenterology 2.56 1:39,066 1.29 1:77,304 2.80 1:35,702Hematology & Oncology 3.07 1:32,626 1.54 1:65,078 3.36 1:29,796Infectious Disease 9.04 1:11,067 5.24 1:19,080 9.76 1:10,247Nephrology 1.17 1:85,530 0.64 1:155,551 1.27 1:78,775Neurology 3.04 1:32,913 1.71 1:58,645 3.29 1:30,374Psychiatry 11.14 1:8,978 5.73 1:17,443 12.17 1:8,219Rheumatology 0.38 1:262,866 0.19 1:520,620 0.42 1:240,212Other Specialty 7.44 1:13,448 4.51 1:22,173 7.99 1:12,510
General Surgery 7.30 1:13,700 6.51 1:15,358 7.45 1:13,424Neurological Surgery 1.34 1:74,867 0.54 1:186,207 1.49 1:67,211Obstetrics & Gynecology 9.66 1:10,351 6.57 1:15,221 10.25 1:9,757Ophthalmology 4.26 1:23,499 2.69 1:37,133 4.55 1:21,963Orthopaedic Surgery 6.92 1:14,459 5.20 1:19,239 7.24 1:13,805Plastic Surgery 1.48 1:67,412 0.58 1:172,952 1.66 1:60,391Urology 2.36 1:42,390 1.92 1:52,168 2.44 1:40,929Other Surgical Specialties 1.22 1:82,180 0.55 1:180,285 1.34 1:74,461
Emergency Medicine 11.07 1:9,035 7.76 1:12,881 11.70 1:8,549Anesthesiology 10.56 1:9,473 4.75 1:21,057 11.66 1:8,574Radiology-Diagnostic 9.76 1:10,242 5.52 1:18,112 10.57 1:9,459Pathology-Anatomic and Clinical 3.89 1:25,718 2.20 1:45,392 4.21 1:23,757
Pediatric Cardiology 0.27 1:366,502 0.05 1:1,822,171 0.31 1:318,095Pediatric Neurology 0.12 1:836,895 0.06 1:1,546,084 0.13 1:769,644Other Pediatric Subspecialties 2.28 1:43,956 0.47 1:212,587 2.62 1:38,186*Ratio's generated after all reported specialties were normalized to ACGME standard definitions and group accordingly. Individual provider practice location relative to OMB rural and rural population was utilized to create rural and urban ratios.
Medical Specialties
Surgical Specialties
Hospital-Based
Pediatric Subspecialties
Primary Care
Created by NCAHD using National Enhanced State Licensure Data and 2015 Census Population Estimates
ACGME Specialties
National Rural Urban
2015 Physician Specialty Ratios*
2008-2012 Healthcare Workforce ShiftRh
ode
Islan
d
Iow
a
Utah
New
Yor
k
Nort
h Da
kota
Was
hing
ton
Miss
ouri
New
Mex
ico
Oreg
on
Haw
aii
Alab
ama
Neva
da
Mon
tana
Wes
t Virg
inia
Arka
nsas
Indi
ana
Nebr
aska
Colo
rado
Alas
ka
Kans
as
New
Jers
ey
Sout
h Ca
rolin
a
Sout
h Da
kota
Geor
gia
Kent
ucky
Arizo
na
Tenn
esse
e
Mas
sach
usett
s
Okla
hom
a
Loui
siana
Min
neso
ta
Ohio
New
Ham
pshi
re
Mich
igan
Mar
ylan
d
Miss
issip
pi
Virg
inia
Penn
sylv
ania
Mai
ne
Texa
s
Illin
ois
Flor
ida
Nort
h Ca
rolin
a
Idah
o
Wisc
onsin
Verm
ont
Dela
war
e
Calif
orni
a
Wyo
min
g
Conn
ectic
ut
-60.0
-40.0
-20.0
0.0
20.0
40.0
60.0
80.0
100.0
Migration of Primary Care Workforce between Urban vs Rural per 100,000 population
from 2008 to 2012
Greater Migration towards Urban
Greater Migration towards Rural
28
2008-2012 Healthcare Workforce Shift
Audiologists
Certified Nurse Midwives
Certified Registered Nurse Anesthetists
Podiatrists
Optometrists
Chiropractors
Dental Hygienists
Speech-Language Pathologists
Psychologists
Physical Therapists
Dentists
Pharmacists-10000
0
10000
20000
30000
40000
50000
Migration of Allied Healthcare Workforce between Urban vs Rural from 2008 to 2012
Greater Migration towards Urban
Greater Migration towards Rural
29
National Healthcare Workforce Data Collection Process
How weCreateThe EnhancedStateLicensureData
FifteenHealthcareProvidersFrom50 differentStateLicensureBoards
Process Takes3-4 months
2 FTE
State Licensing Data Comparison
• Free public access to all of the enhanced state licensure data
• Visualize the individual providers at a national and regional level
• Zoom in to see state, county and zip code aggregates of providers and demographic information at the total number or percentage
• Users can download the data as a spreadsheet
NCAHD’s Healthcare Workforce Mapping Portal - Features
Website: http://gis.ncahd.org
NCAHD’s Healthcare Workforce Mapping Application
Website: http://gis.ncahd.org
27
Examples of Unique Mapping and Analysis Service
30
Demographic Profile of Florida’s Psychologists
National • Total Instate Licensed Psychologists = 89,595
• % Change from 2008 = 4%
• Total in Rural Areas* = 8,478• % of all psychologists serving rural = 10%
State Average = 17%• Total in Mental Health Professional
Shortage Areas (HPSA) = 16,558• % of all physicians in Mental HPSA = 19%
State Average = 30%
Florida2010 NCAHD Enhanced State Licensure • Total Instate Licensed Psychologists = 3,815
• % Change from 2008 = 7%• Total/% in Rural Areas* = 148/4%
• State Rank = 44• Total/% in Florida in Mental HPSA = 537/14%
State Rank = 34
• Data Research – aside from our enhanced state licensure (ESL), we find and process many other state and national demographic, socio-economic, health indicators, etc. to support research, proposal development, planning, etc.
• Mapping and Spatial Analysis• Alumni Tracking – validate school’s existing alumni and/or find missing
alumni; perform analysis on specialty, proximity to rural and underserved, etc.
• Trend analysis on Physician, NP, PA and 14 other providers at the county, state and national level
• Healthcare workforce economic impact analysis – for medical schools and entire primary care workforce
• Future - Time Series mapping/data subscription service• Internet Mapping Portal Development – current projects with
Tennessee and West Virginia; Ohio and Virginia in discussion phase
Current and Future Research and Product/Services Development
