Physician Access Index Tracks 33 Patient Access Variables To Rate States

By Christine Kern, contributing writer

A new ranking system complied by Merritt Hawkins tracks 33 different patient access variables in order to rate states according to the accessibility of patients to physicians.

The Physician Access Index has found Massachusetts, New Hampshire, Vermont, Delaware, and Maryland are at the top of the scale with the most positive physician access results, while Mississippi, Texas, New Mexico, Nevada, and Oklahoma bring up the rear.

“When it comes to accessing physicians, not all places or all patients are equal,” explained Mark Smith, president of Merritt Hawkins in a statement. “As the healthcare system evolves, there will be clear access ‘haves’ and ‘have-nots,’ and the rankings reflect these imbalances.”

The Index tracks 33 separate metrics that influence access to physicians, physician assistants (PAs), and nurse practitioners (NPs) including physicians per capita, physicians trained per capita, physicians trained per capita who remain in-state, PAs and NPs per capita, percentage of insured population, physician Medicare and Medicaid rates, household income, telehealth rates, urgent care centers and retail care clinics per capita, and percent of physicians nearing retirement.

While the Index can be helpful in assessing overall access, it is important to note states can experience a wide range of access scores within the state. “No state is without its challenges and strong points where physician access is concerned,” Smith said. “There are pockets of patients with poor physician access in highly ranked states and pockets of patients with good physician access in states with low rankings.”

Smith explained the data demonstrate where states have physician access challenges and how these challenges might be addressed. While poverty rates and low per capita incomes can be key barriers to physician access, these are societal problems that take time to resolve, according to Smith. Where states have more control over addressing challenges is in taking more immediate steps by funding residency positions and offering educational loan repayment and other retention incentives. And states can also take steps to reduce barriers to telehealth implementation, expand the practice parameters of NPs and PAs, increase or expand FQHCs, and expand eligibility requirements for Medicaid through the Affordable Care Act.

“The best way to ensure better access to physicians is to enhance economic opportunity for all Americans, reducing barriers to care,” Smith said. “The federal government also needs to remove its current cap on funding for physician training, which is inhibiting physician supply as demand for doctors is growing.”

One particularly troubling factor that will affect physician access is the predicted shortfall of physicians by 2025, as reported on by Health IT Outcomes.