meeting new mexico’s health care workforce needs, 2016€¦ · meeting new mexico’s health care...
TRANSCRIPT
MEETING NEW MEXICO’S HEALTH CARE WORKFORCE NEEDS, 2016
UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
Executive Summary of the New Mexico Health Care Workforce Committee 2016 Annual Report
Background Since 2012, the New Mexico Health Care Workforce Committee has been tasked by the New Mexico Legislature with assessing the extent of the state’s provider shortage and conducting analyses to help guide efforts to remediate these challenges. The state is making steady progress, but shortages persist.
Shortages In its October 1, 2016, report to the Legislature, the Committee estimated that 2,075 primary care physicians, 1,293 certified nurse practitioners and clinical nurse specialists, 698 physician assistants, 253 obstetricians and gynecologists, 177 general surgeons, 309 psychiatrists, 1,131 dentists and 1,911 pharmacists were practicing in the state. As in previous years, New Mexico’s rural and frontier counties were found to be furthest below national benchmarks for health care workforce supply. The state’s metropolitan areas are also affected, however.
Compared with data reported in 2015, New Mexico had a net gain of primary care physicians, certified nurse practitioners and clinical nurse specialists, physician assistants, obstetricians and gynecologists, general surgeons, psychiatrists and dentists. The state had a net loss of pharmacists.
Still, substantial health care provider shortages of all types persist statewide, particularly in rural and frontier areas. New Mexico would need an estimated 124 primary care physicians, 201 certified nurse practitioners and clinical nurse specialists, 128 physician assistants, 36 obstetricians and gynecologists, 16 general surgeons, 109 psychiatrists, 67 dentists and 292 pharmacists to enable all counties to meet national benchmarks for these providers.
The state map shown here illustrates New Mexico’s primary care workforce – primary care physicians, certified nurse practitioners and clinical nurse specialists and physician assistants – compared to national benchmarks for these practitioners. Maps for other practitioners are shown on the following pages. Both the adequacy of behavioral health workforce statewide and New Mexico’s ability to “grow its own” primary care practitioners through
MEETING NEW MEXICO’S HEALTH CARE WORKFORCE NEEDS, 2016
residencies continue to be areas of concern. The Committee’s recommendations address these concerns, as well as its own ability to conduct future research (see “Potential Solutions”).
Update On The Committee’s Previous RecommendationsThe New Mexico Legislature and health profession boards have acted upon many of the Committee’s recommendations in recent years. As a result, state funding has increased for nursing program expansion, residencies, health professional financial aid programs, telehealth, and dental and veterinary training through the Western Interstate Commission for Higher Education. The New Mexico Counseling and Therapy Practice Board, the Board of Psychologist Examiners and the Board of Social Work Examiners have agreed to expand or examine expanding the definition of supervised practice toward independent licensure to include tele-mentoring.
Looking ForwardThe New Mexico Health Care Workforce Committee outlined plans for its 2017 report to expand its analysis to include certified nurse midwives, psychologists, counselors, social workers, emergency medical technicians, physical therapists and occupational therapists. As in the 2016 report, the behavioral health workforce will be examined in-depth.
SAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORAHARDING
SANTAFE SAN MIGUEL
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
QUAY
+ 1
- 1
- 1
- 1
0
- 2
- 2+ 1+ 4- 3
+ 68
+ 401
- 36
0
- 10
0
- 1
- 21
- 6
+ 23
- 9
+ 2
- 14
+ 13
+ 2
- 10
- 2
+ 15
0
- 3
+ 1
+ 18
- 2
- 41+ 1
- 10 + 1
- 19 0
+ 1
- 44+ 10
- 1
- 4+ 244 0
- 24- 4
- 7+ 1
- 2- 2 - 4 - 1
- 11
- 13
+ 11
- 15- 2
+ 6
+ 2
- 3
- 3
- 1
+ 6
- 1- 2
+ 90 - 1
- 10 0
0
+ 3+ 13
- 1
- 4+ 153 - 1
- 15- 3
- 6- 1
- 3- 1 - 5 - 3
- 8
- 13
- 7
- 6+ 2
- 30
- 4
+ 1
+ 9
+ 6
- 3
Primary Care Workforce Compared to Benchmarks, 1,2,3 2015
Comparisonsto Benchmarks
Net Providers ator Above Benchmarks
Net Providers 1 - 10Below Benchmark
Net Providers > 10Below Benchmarks
0 PC Physicians(0.79 per 1,000)
0 CNPs/CNSs(0.59 per 1,000)
0 PAs(0.303 per 1,000)
Number Above (+) orBelow (-) Benchmark for:
The Committee also anticipates analyzing the registered nurse workforce, with an emphasis on the distribution of bachelor of science in nursing-trained nurses, internist MDs’ subspecialties and the state’s Suboxone and naloxone prescribers and providers.
Potential SolutionsThe Committee recommends measures to enhance the quantity and quality of New Mexico health care providers, improve access to behavioral health care and increase incentives for rural practice. These are described in detail in the Committee’s 2016 Annual Report. They include:
For all health professions:
■■ Enhance the physician assistants’ survey with an added practice specialty item.
■■ Maintain funding for the loan-for-service and loan repayment programs at their current levels.
■■ Restructure loan-for-service and loan repayment programs to target the professions most needed in rural areas.
■■ Continue funding for expanded primary and secondary care residencies in New Mexico.
■■ Obtain federal matching funds for loan repayment.
■■ Provide funding for the New Mexico Health Care Workforce Committee.
SAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORA HARDING
SANTAFE
SAN MIGUEL
QUAY
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
- 6
0
- 2
- 1
0
0
0
0+ 10- 1
- 3
0
+ 61
- 8
0
- 2
0
- 1
- 1
+ 3
0
- 9
+ 2
+ 1
0
- 1
0
0
0
0
- 1
+ 1
Ob-Gyns Compared to Benchmark,4 2015Comparisonto Benchmark(2.1 per 10,000Female Population)
At or AboveBenchmark
1 - 5 ProvidersBelow Benchmark
> 5 ProvidersBelow Benchmark
0Number Above (+) orBelow (-) Benchmark
At BenchmarkWith 0 Ob-Gyns
No Surgical Facilityin County
SAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORA HARDING
SANTAFE
SAN MIGUEL
QUAY
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
- 1
- 1
+ 6
+ 1
0
0
0
+ 1+ 3+ 2+ 1
+ 8
+ 3
+ 33
- 5
0
- 1
0
0
- 2
+ 5
0
- 3
+ 1
- 2
0
- 1
0
0
+ 1
0
0
+ 3
General Surgeons Compared to Benchmark, 5 2015
General Surgeonsper 100,000 People
Optimal( > 9.2 Surgeons/100k)
Mild Shortage(3 - 6 Surgeons/100k)
Severe Shortage( < 3 Surgeons/100k)
0Number Above (+) orBelow (-) Benchmark
At Benchmark With0 General Surgeons
No Surgical Facilityin County
Adequate(6 - 9 Surgeons/100k)
For all behavioral health professions:
■■ Expedite professional licensure by endorsement for social workers, counselors and therapists.
■■ Explore opportunities to leverage federal funding for the Health Information Exchange and adoption of electronic health records for behavioral health providers.
■■ Convene a planning group to develop statewide telehealth infrastructure to deliver behavioral health services via telehealth to rural communities.
■■ Add social workers and counselors to professions eligible for New Mexico’s Rural Healthcare Practitioner Tax Credit program.
■■ Identify funding for efforts to support and prepare candidates from diverse backgrounds to complete graduate degrees in behavioral health fields.
■■ Support Medicaid funding for community-based psychiatry residency programs in federally qualified health centers.
One 2016 recommendation, to correct the omission of practice specialty from the physicians’ online license renewal survey, has already been addressed by the Regulation and Licensing Department.
We look forward to action on the remaining recommendations in order to close the gap between rural and urban counties and allow all New Mexicans access to the care necessary for improved physical and behavioral health.
SAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORA HARDING
SANTAFE
SAN MIGUEL
QUAY
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
- 10
- 3
- 4
0
0
+ 5
- 1
- 1- 2- 2- 5
+ 28
0
+ 63
- 5
- 1
- 2
0
- 3
- 7
- 5
- 5
- 13
- 2
- 8
- 12
- 2
- 3
- 1
- 1
- 1
- 3
- 7
Psychiatrists Compared to Benchmark, 6 2015
Comparisonto Benchmark(1 per 6,500)
At or AboveBenchmark
1 - 5 ProvidersBelow Benchmark
> 5 ProvidersBelow Benchmark
0Number Above (+) orBelow (-) Benchmark
At BenchmarkWith 0 Providers
SAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORA HARDING
SANTAFE
SAN MIGUEL
QUAY
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
- 27
0
- 13
- 1
- 1
- 4
- 1
0- 1- 2- 22
- 8
- 1
+ 542
- 1
- 3
- 10
+ 1
- 1
- 30
- 5
- 11
+ 33
- 11
- 26
- 46
- 3
- 13
- 2
- 1
- 3
- 8
- 37
Pharmacists Compared to Benchmark,8 2015
Comparisonto Benchmark(0.78 per 1,000)
At or AboveBenchmark
1 - 5 ProvidersBelow Benchmark
> 5 ProvidersBelow Benchmark
0Number Above (+) orBelow (-) Benchmark
NotesSAN JUAN
McKINLEY
CIBOLA
CATRON
GRANT
HIDALGO
RIO ARRIBA
LOS ALAMOS
SANDOVAL
BERNALILLO
VALENCIA
SOCORRO
SIERRA
LUNA
TAOS COLFAX UNION
MORA HARDING
SANTAFE
SAN MIGUEL
QUAY
TORRANCE
GUADALUPE
CURRY
ROOSEVELT
DE BACA
LINCOLN
CHAVES
LEA
EDDY
OTERO
DOÑA ANA
+ 31
+ 2
+ 9
- 2
0
- 1
- 1
- 2- 1+ 4- 5
+ 55
+ 8
+ 233
- 7
- 1
- 4
- 1
- 5
- 11
- 4
- 2
+ 4
- 3
- 8
+ 18
- 1
- 3
- 2
0
0
- 3
0 At or AboveBenchmark
1 - 5 ProvidersBelow Benchmark
> 5 ProvidersBelow Benchmark
0Number Above (+) orBelow (-) Benchmark
At BenchmarkWith 0 Dentists
Dentists Compared to Benchmark, 7 2015
Comparisonto Benchmark(1 per 2,500)
1. Center for Workforce Studies. 2011 State Physician Workforce
Data Book. Association of American Medical Colleges; 2011.
https://www.aamc.org/download/263512/data/statedata2011.
pdf. Accessed August 28, 2015.
2. Henry J. Kaiser Family Foundation. State Health Facts: Total
Nurse Practitioners per 100,000 Population. http://kff.org/
other/state-indicator/nurse-practitioners-per-100000-pop/.
Accessed August 28, 2015.
3. National Commission on Certification of Physician Assistants.
2013 Statistical Profile of Certified Physician Assistants. NC-
CPA; 2014. https://www.nccpa.net/Upload/PDFs/2013Statisti-
calProfileofCertifiedPhysicianAssistants-AnAnnualReportoft-
heNCCPA.pdf. Accessed August 28, 2015.
4. Rayburn W. The Obstetrician/Gynecologist Workforce in the
United States: Facts, Figures, and Implications 2011. The Amer-
ican Congress of Obstetricians and Gynecologists; 2011.
5. Ricketts TC, Thompson K, Neuwah S, McGee V. Developing
an Index for Surgical Underservice (July 2011) - Indexsurg.
ashx. American College of Surgeons Health Policy Research
Institute; 2011. https://www.facs.org/~/media/files/advocacy/
hpri/indexsurg.ashx. Accessed August 28, 2015.
6. Burvill PW. Looking Beyond the 1:10,000 Ratio of Psychiatrists
to Population. Aust N Z J Psychiatry. 1992; 26(2):265-269.
7. The benchmark for estimating dentist shortage is 1 dentist per
2,500 population, twice the 1:5,000 minimum threshold for
HPSA designation (Health Resources and Services Admin-
istration. Criteria for Determining Priorities Among Health
Professional Shortage Areas. Fed Regist. 2003; 68(104):32531-
32533), known to be a severe shortage.
8. Bureau of Health Professions. The Adequacy of Pharmacist
Supply: 2004 to 2030. Health Resources and Services Admin-
istration; 2008. http://bhpr.hrsa.gov/healthworkforce/reports/
pharmsupply20042030.pdf. Accessed August 28, 2015.