Of all the problems facing the American healthcare system today, the most alarming one continues to grow daily: the shortage of healthcare providers.
All insurance agents need to read this article because there’s no sign of this going away anytime soon.
The Bureau of Health Workforce Health Resources and Services Administration (HRSA) in the US Department of Health & Human Services released its quarterly Designated Health Professional Shortage Areas Statistics report on Dec. 31, 2024.
This report divides the country into geographic levels, statistical regions, and statewide data. Each geographical designation assumes a provider-to-population ratio of 3,000-3,500 population to 1 provider.
This criterion determines a coverage percentage for the providers in the geographical designation. Several providers needed to have enough providers covering this geographical designation to be 100% or adequately covered.
The report counts three types of providers: primary care, mental health, and dental.
Overall, the numbers show:
- 47.23% of the nation with an adequate number of primary care providers,
- 32.23% of the nation with a sufficient number of dental providers,
- 26.44% of the nation has an adequate number of mental health providers.
So, more than half the nation does NOT have enough primary care providers.
A little more than 66% of the nation does not have enough dental providers, and nearly 75% does not have enough mental health providers.
To look at these shortages another way, the US needs 13,272 more primary care providers, 10,153 more dental providers, and 6,200 more mental health providers to meet the “adequate care” ratio for our population’s healthcare needs.
Only 19 of the 51 states and the District of Columbia have a primary care provider adequacy of 50% or higher.
The 10 states and the District of Columbia with the LOWEST adequacy percentages are below:
- District of Columbia 0.23%
- Delaware 14.85%
- Alaska 20.71%
- Missouri 22.27%
- Maryland 28.76%
- Iowa 31.30%
- North Dakota 33.24%
- Oklahoma 33.26%
- South Dakota 33.59%
- Kentucky 35.01%
The 10 states with the highest numbers of primary care providers needed are:
- Florida 1,336
- New York 1,013
- California 971
- Texas 885
- Georgia 586
- Illinois 527
- Washington 499
- Arizona 3493
- Michigan 490
- Missouri 476
All but two of these states have an adequacy percentage of less than 50%.
The numbers in the report are even worse for dental and mental health providers.
Research shows these numbers will only worsen in these groups, with one data source saying 55% of all primary care physicians will turn 65 by 2035.
What Are the Solutions?
There are a few ways to address this shortage, with some already in motion.
Most medical practices already have physician assistants and nurse practitioners seeing patients. Some states are looking to form alliances, allowing these professionals to have their credentials recognized and accepted in multiple states.
This isn’t currently possible in most states, so this change will help make these professionals more available.
The challenge with this solution is that these professionals must still be supervised by physicians, who must approve of their actions as part of their work with patients. The shortage in some states is so acute that having supervisor physicians will be challenging.
Ultimately, we need more providers in these care areas, and the one solution that would address this is the most controversial. Thousands of credentialed medical and dental professionals from outside the United States are here in our country now as naturalized citizens or going through the citizenship process.
However, these possible care providers are prohibited from working in their fields as most states and other credentialing bodies in the US do not recognize the training they received from overseas.
Suppose the states and credentialing bodies recognize this training by allowing them to take and pass the board examinations all other providers must take to work in their fields before receiving a license. In that case, most of these shortages would disappear.
What Should Insurance Agents Do?
- Manage your health insurance clients’ expectations about who they’ll visit and talk to on a primary care physician or dental visit. Let them know it’s okay to see a Physician’s Assistant, Nurse Practitioner, Dental Assistant, or Dental Hygienist for basic care needs and exams.
- Work with insurance carriers to locate new primary care physicians and dentists trying to build their practices and place clients who want to see a physician or dentist regularly for chronic conditions or serious health issues. This helps these new providers while giving your clients what they need—access to a dentist or physician. Tell your clients they’re seeing a new provider because they have more time and availability to see them regularly.
- Talk to your elected officials at the state and federal levels about the shortage and ask them what they are doing about it. Tell them what you see daily with clients having difficulties seeing the dentist, primary care physician, or mental health physician they need for care.
There are many issues to address, including complicated political dynamics in our country. Still, provider shortages are something we must consider, as this impacts all who want to have these healthcare options available moving forward.
Agility will keep you abreast of the latest news on this provider shortage and its impact on four healthcare systems. Our national footprint enables us to develop partnerships and programs that provide insights into the provider world.
Many agents working with Agility have great partnerships with providers they regularly access for their mutual benefit.
Contact Agility now at (866) 590-9771 or email [email protected] to learn how to find and develop mutually beneficial provider partnerships. Agility can also add you to our weekly free email list for more tips and other vital information!
