Packham July 25, 2016

Transcription

1 Packham July 25, 216 Health Workforce in Nevada Supply and Demand Update John Packham, PhD Office of Statewide Initiatives University of Nevada, Reno School of Medicine July 25, 216 Forces Driving Health Workforce Demand Primary Factors Population growth and aging Reform-related insurance coverage expansions Economic growth, e.g., Tesla/Faraday effects Important, but Secondary Factors Population health (demand need) Health care system change, e.g., integration Science and technological change, e.g., telehealth 2 Health Care Employment in Nevada Number of Jobs (Thousands) 25 to 215 Health Care Employment in Las Vegas Number of Jobs (Thousands) 25 to Health Care and Social Assistance Ambulatory Health Care Services Hospitals Health Care and Social Assistance Ambulatory Health Care Services Hospitals Source: Nevada Department of Employment, Training, and Rehabilitation (216). 3 Source: Nevada Department of Employment, Training, and Rehabilitation (216). 4 Estimated Employment in Nevada June 215 to June 216 (Estimates in Thousands) Nevada Statewide June 215 June 216 Change % Change Ambulatory Care % Hospitals % Construction % Manufacturing % Leisure and Hospitality % All Industries 1, , % Projected Demand for Health Care Workers by Industry in Nevada from 212 to 222 Health Care and Social Assistance Sector: + 17,661 jobs (+16.3%) Ambulatory Care: 6,877 jobs (+15.8%) Offices of physicians: 1,62 jobs (+9.5%) Offices of dentists: 78 jobs (+9.6%) Hospitals: 3,821 jobs (+11.9%) Skilled Nursing Facilities: 2,585 jobs (+22.7%) Source: Nevada Department of Employment, Training, and Rehabilitation (216). 5 Source: Nevada Department of Employment, Training, and Rehabilitation (216). 6 Office of Statewide Initiatives Page 1

2 Packham July 25, 216 Health Care Occupations in Nevada Job Postings 215 Registered Nurses Medical and Health Services Managers Surgeons and Specialty Physicians Nursing Assistants Critical Care Nurses Physical Therapists Health Information Technicians Medical Secretaries Nurse Practitioners Primary Care Physicians Occupational Therapists Licensed Practical Nurses Medical Assistants Clinical Laboratory Technicians Physician Assistants Speech-Language Pathologists Pharmacy Technicians Educational and Vocational Counselors Pharmacists Mental Health Counselors 2,43 1,925 1,423 1,367 1,358 1, Source: OSI analysis of Burning Glass/Labor Insights data (216). 8,645 1, 2, 3, 4, 5, 6, 7, 8, 9, 1, 7 5, 4,5 4, 3,5 3, 2,5 2, 1,5 1, 5 Demand for Physicians in Nevada Job Postings 21 to 216 1,984 2,77 1,834 2, Projected 1,981 3,466 4,366 8 Demand for Physicians in Nevada Job Postings 213 to 215 Demand for Physicians in Clark County Job Postings 213 to 215 2,5 2,214 1,8 2, 1,5 1, 1,586 1,116 1,5 1, , Health Care Other Industries Health Care Other Industries Source: OSI analysis of Burning Glass/Labor Insights data (216). 9 Source: OSI analysis of Burning Glass/Labor Insights data (216). 1 Demand for APRNs in Nevada Job Postings 213 to 215 Demand for APRNs in Clark County Job Postings 213 to 215 3, 2,5 2,662 2,5 2, 2,147 2, 1,5 1,275 1,689 1,5 1,98 1,381 1, 1, Health Care Other Industries Health Care Other Industires Source: OSI analysis of Burning Glass/Labor Insights data (216). 11 Source: OSI analysis of Burning Glass/Labor Insights data (216). 12 Office of Statewide Initiatives Page 2

3 Packham July 25, 216 Demand for APRNs in Washoe County Job Postings 213 to 215 Demand for APRNs in Rural Nevada Job Postings 213 to Health Care Other Industries Health Care Other Industries 3 Source: OSI analysis of Burning Glass/Labor Insights data (216) Demand for Physician Assistants in Nevada Job Postings 213 to Health Workforce Demand in Nevada Overall growth in health care employment (16.3%) is projected to exceed the average for all occupations in Nevada (13.8%) through Health Care Industries Other Industries Population growth and aging, as well as ACA-related insurance coverage expansions will generate above average demand for health care workers in Nevada 11 high demand health care occupations are ranked among the top 1 occupations in Nevada with the largest projected job growth through 222 Source: OSI analysis of Burning Glass/Labor Insights data (216) Health Workforce Supply in Nevada Steady growth in the number of licensed health professionals across most professions Treading water in the number of licensed health professionals per capita for some, not all Severe health workforce shortages compounded by an aging health workforce and ensuing ACArelated demand Persistent specialty shortages and geographic maldistribution of physicians and most other health professionals Number of Licensed Allopathic Physicians (MDs) per 1, Population in Nevada 24 to Urban North Urban South Rural and Frontier Nevada Source: OSI analysis of unpublished data from Nevada State Board of Medical Examiners (216) Office of Statewide Initiatives Page 3

4 Packham July 25, 216 Number of Licensed Registered Nurses (RNs) per 1, Population in Nevada 24 to 214 Number of Licensed Advanced Practitioners of Nursing (APNs) per 1, Population in Nevada 24 to 214 1, Urban North Urban North Urban South Rural and Frontier Nevada Urban South Rural and Frontier Nevada Source: OSI analysis of unpublished data from Nevada State Board of Nursing (216). 19 Source: OSI analysis of unpublished data from Nevada State Board of Nursing (216). 2 Primary Care Physicians Number per 1, Population Surgeons and Specialty Physicians Number per 1, Population Family Medicine General Practice Internal Medicine Pediatrics OB/Gyn Elko Nevada Mountain Region U.S... General Surgery Orthopedic Surgery Cardiovascular Gastroenterology Psychiatry Disease Elko Nevada Mountain Region U.S. Source: AMA. Physician Characteristics and Distribution in the US (215) and OSI analysis of unpublished licensure data from the NSBME and NSBOM (216) 21 Source: AMA. Physician Characteristics and Distribution in the US (215) and OSI analysis of unpublished licensure data from the NSBME and NSBOM (216) Primary Care Physicians Number of MDs and DOs per 1, Population Family Medicine General Practice Internal Medicine Pediatrics OB/Gyn Clark Washoe Balance of State Source: OSI analysis of unpublished data from the Nevada State Board of Medical Examiners and Nevada State Board of Osteopathic Medicine (216) Surgeons and Specialty Physicians Number of MDs and DOs per 1, Population General Surgery Orthopedic Surgery Cardiovascular Disease Gastroenterology Clark Washoe Balance of State Psychiatry Source: OSI analysis of unpublished data from the Nevada State Board of Medical Examiners and Nevada State Board of Osteopathic Medicine (216) Office of Statewide Initiatives Page 4

5 Packham July 25, 216 Primary Care Health Professional Shortage Areas (HPSAs) 216 Dental Health Professional Shortage Areas (HPSAs) ,156 Nevadans reside in a primary care HPSA (33.7%) 93,241 Nevadans reside in a dental HPSA (31.7%) 815,657 urban residents in Nevada (31.8% of urban residents) live in a primary care HPSA, including 613, residents of Clark County 757,815 urban residents in Nevada (29.5% of urban residents) live in a dental HPSA, including 612,71 residents of Clark County 142,476 rural residents (49.8% of rural residents) live in a primary care HPSA 9 single-county primary care HPSAs 145,426 rural residents (5.8% of rural residents) live in a dental HPSA 8 single-county dental HPSAs Source: OSI analysis of data from the Health Resources Services Administration (216). 25 Source: OSI analysis of data from the Health Resources Services Administration (216). 26 Mental Health Professional Shortage Areas (HPSAs) million Nevadans reside in a mental HPSA (53.3%) 1.2 million urban residents in Nevada (48.1% of urban residents) live in a mental HPSA, including 736,98 residents of Clark County 286,251 rural residents (1.% of rural residents) live in a mental HPSA 16 single-county mental HPSAs Source: OSI analysis of data from the Health Resources Services Administration (216). 27 Policy Levers to Improve Workforce Supply Higher education programs and capacity esp., public programs and opportunities Health professions licensing and regulation State policy and budget esp. funding for higher education health education programs Federal policy esp. support for health workforce education and training K-12 education pipeline 28 Proactive versus Reactive Health Workforce Research and Planning Need for better data on health workforce demand, esp., industry-specific workforce demand and population health needs Need for better data on current and projected supply of health workforce, esp., health professions Minimum Data Sets (MDS) and graduate retention from state health education programs 29 Proactive versus Reactive Health Workforce Research and Planning (continued) Need for real world health workforce supply and demand modeling and estimates, e.g., primary care demand, cultural competency What s happening with health workforce planning in Nevada? 3 Office of Statewide Initiatives Page 5

6 Packham July 25, 216 Case Study: Estimating Primary Care Supply and Demand in Washoe County Demand Estimating primary care visits age, gender, income, zip code Evolving utilization patterns, e.g., insurance effects Supply Family medicine and general practice, Pediatricians, Internists Retirees, part-time vs. full-time, productivity Role of nurse practitioners & physician assistants Retention of Physicians Completing UNSOM GME in Nevada 26 to (N=13) Beginning Practice Continuing GME or Other Remaining in Nevada 42.7% 7.8% 5.5% Leaving Nevada 33.% 16.5% 49.5% 75.7% 24.3% 1.% 26 to 215 (N=773) Beginning Practice Continuing GME or Other Remaining in Nevada 44.1% 7.4% 51.5% Leaving Nevada 35.8% 12.7% 48.5% 79.9% 2.1% 1.% 31 Source: Griswold & Packham. OSI Annual UNSOM GME Exit Survey (215). 32 Retention of Registered Nurses Completing NSHE programs in Nevada 29 to 215 Recent Workforce Reports from the Office of Statewide Initiatives 215 (N=349) Have a Job Seeking a Job or Other Remaining in Nevada 25.4% 62.7% 87.7% Leaving Nevada 1.1% 1.8% 12.3% 26.5% 73.5% 1.% 29 to 215 (N=2,841) Have a Job Seeking a Job or Other Remaining in Nevada 29.% 58.7% 88.2% Leaving Nevada 1.% 11.3% 11.8% 3.% 7.% 1.% Source: Griswold & Packham. OSI Analysis of NSHE Graduating Nursing Student Surveys (216). 33 UNSOM GME Exit Survey 26 to 216 (forthcoming) Physician Workforce in Nevada 216 Edition Health Workforce Supply in Nevada 216 Edition Health Care Careers in Nevada Edition Nevada Instant Atlas 34 John Packham, PhD Director of Health Policy Research Office of Statewide Initiatives University of Nevada, Reno School of Medicine (775) jpackham@medicine.nevada.edu Office of Statewide Initiatives Page 6