As the Patient Protection and Affordable Care Act (ACA) coverage provisions are progressing, demand for health care is growing. This report estimates the supply of physician assistants (PAs), nurse practitioners (NPs), and certified nurse midwives (CNMs) as crucial components of the state’s health provider capacity. The study used licensing board data, training and graduation numbers from PA and NP colleges, and interviews with providers. The study calculates Arizona’s provider to population ratio, compares it to the national average, reports the number of PA, NP, and CNM providers attending Arizona schools by specialty and primary care, and estimates the number needed in Arizona to meet national benchmarks.
Arizona has a strong health infrastructure to build on, and unprecedented opportunities to transform its health system. In Yet Arizona has unique challenges – it has two large urban and many widely dispersed rural populations, a high percentage of uninsured overall, and uninsured rates exceeding 30% in rural, border, Hispanic/Latino and American Indian populations. Many face poverty, unemployment and limited access to health care.
The health professions examined in this report are physician assistants, nurse practitioners, and certified nurse midwives. Workforce data is presented from 2007 to 2013 with a focus on the current situation. The results from other health care workforce studies are presented to add context to the data and information presented.
• The Arizona health workforce is aging - 54% of CNMs, 41% of NPs, 26% of PAs are age 55 or older;
• Many plan to retire in the next ten years;
• Many choose where to practice based on job description and location;
• Only 58% of PAs, 54% of NPs and 50% of CNMs accept new Medicare/Medicaid patients;
• The majority of PAs, NPs, CNMs work in direct patient care, and over 40 hours a week;
• Rural Arizona has fewer NP and PA providers per capita than urban areas;
• Urban Arizona has fewer CNMs per capita than rural areas;
• Most PA, NP, and CNM providers do not own their practice;
• CNMs identified reimbursement rates as a reason to stop practicing in the next ten years;
• The majority of PAs, NPs, and CNMs practicing in Arizona were recruited from other states;
• Only 50 to 60% of the PAs and NPs trained in Arizona practice in Arizona;
• There are numerous opportunities to address workforce shortages and improve access to high
How to Use the Report
The report is divided into six major sections:
Introduction that describes the current environment for Arizona’s workforce that includes: scope of practice, training standards, liability insurance, reimbursement for health services, funding for rural health infrastructure, current workforce coverage in Arizona and neighboring states.
Survey results that describes demographic distributions, educational attainment, current employment, future plans, and where the workforce is trained.
Recommendations and Conclusion on how to improve workforce supply, distribution, utilization and data collection.
There is also a section of Methodology and detailed Survey Response Data.
The analysis investigates differences between rural and urban workforce using rural urban commuting areas (RUCAs) classification. There are 26 figures (graphs), 49 tables, and 8 maps in the report.