A recent policy analysis by the National Institute for Health Care Reform (NIHCR) considers ways to address the shortage of primary care providers. There are an estimated 400,000 primary care providers in the country, including physicians, advanced practice nurses, and physician assistants. Estimates vary regarding the provider shortage, but most studies indicate there is a shortage, especially in certain areas and for certain segments of the population.
The federal health reform law includes provisions to address the shortage, but also will likely increase demand for primary care providers, by extending insurance coverage to more people. Some examples of provisions of the federal law that could address the shortage of primary care providers include (1) payment and care delivery reforms, (2) scholarships for students planning to practice primary care, and (3) loan forgiveness and other incentive for primary care providers.
The NIHCR analysis highlights two other policy options to expand primary care capacity. According to NIHCR, these options may have greater short-term impact that those described above. One option is to expand the scope of practice of non-physician primary care providers. For example, the analysis notes that two-thirds of states with a primary care physician shortage also have restrictive scope of practice laws.
Another option is to adopt payment policies that foster increased efficiency among primary care providers. For example, payment models that create incentives for the team-based provision of health care may allow providers to extend care to more patients, although there is uncertainty regarding this issue.
