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					Measuring Supply and Demand
 for Healthcare Professions



        LINDA M. LACEY
                P R E S I D E NT
   LA C E Y R E S E A R C H A S S O C I A TE S
                       My background

 15 years as the Associate Director: Research for the
 North Carolina Center for Nursing
    Supply/demand cycle of research
    Extensive use of „administrative‟ data
    Primary data collection efforts
      To address supply-side issues the administrative data could not
      To collect demand data from employers

 Research Associate with BC/BS of NC
 Research Associate & Project Manager with the Cecil
 G. Sheps Center for Health Services Research
      Mission of the Virginia HWDC

To improve the healthcare system in the
  Commonwealth by:
 improving data collection and
 measurement of the healthcare
  workforce
 through regular assessment of
  workforce supply and demand.
                   Mission Implications

 Improve upon current data collection efforts – if
     needed
     “Accurate and appropriate data collection is critical in
     order to be able to plan for the future and provide access
     to quality healthcare.”
          - VA Healthcare Reform Commission
1. Align data collection surveys with long-range
   data needs
2. Implement data collection strategies that ensure
   data quality and completeness.
              Mission Implications

 Focus on measurement of workforce metrics that
 illuminate where and how people work

1. Include these critical elements in survey instruments
    Productivity (hours worked)
    Practice location(s) by county
    Practice type
    Personal demographics
    Professional demographics
Factors affecting supply in the future

 „aging out‟ – retirement    Demographic
  of the baby boomers         bottleneck - fewer
 labor productivity - more   young workers to
  part-timers?                recruit into anything
 New entrants at older      Capacity limits in our
  ages = fewer years in the   education systems
  profession / decreased     Bottle-necks created
  physical ability?           by a shortage of
 Poor image of health care   qualified faculty
  as a career choice
         ROI for high quality supply data

 The ability to track changes in number,
  composition, location, and work behavior in
  each professional group over time.
 A source of Virginia-specific data for
  forecasting
 May reveal unanticipated shifts/trends
 More effective and cost-efficient public policy
    by tracking intervention outcomes applied to the
     education system, recruitment campaigns, loan
     repayment programs, etc.
            Mission Implications

 Regular assessment of supply and demand
 for health professionals means that demand
 data will be needed

1. What is „demand data‟ exactly?
Need vs. Economic Demand

 Need: A level of care or service that
 traditionally has been or ought to be
 consumed by a population group in order to
 attain a desired health status

 Economic Demand: The quantity of services
 or personnel which consumers, insurers, or
 employers are willing to buy at various
 prices.
Factors affecting demand in the future


 Population aging - more     New technologies or
  health care demand           medical discoveries
 Sicker patients             Expanding roles
 Older patients               outside of the
 Inability to substitute
                               traditional practice
  less knowledgeable labor     settings
                              The economy
 Labor productivity
  changes                     Government health
                               care payment policies
          Demand data continued -



 Where will the necessary information come
 from?

 Is there a single source of information for all
 health professions?
     Sources of Demand Data
 Virginia Employment Commission
 Occupational Forecasts by the BLS
 U.S. Census projections
 Forecasting models for both MDs and
  nurses are available through HRSA
  Bureau of Health Professions
 Employer surveys
        ROI for collecting demand data

 Employer surveys –
  Industry-specific information based on Virginia employers
  Ability to collect exactly the information needed to
   address Virginia policy issues
  Benchmark metrics are valued by employers - e.g.
   vacancy rates, turnover rates, weeks-to-fill, etc.
  Ability to do sector and geographic analyses to pinpoint
   problem areas in the Commonwealth
  Ability to match supply characteristics with industry
   sectors to identify potential problems areas -e.g. expected
   retirement rates in hospitals vs other employment settings
      Supply and demand comparisons

 What is the best way of assessing shortage,
 surplus or balance in various healthcare
 workforce groups?

 Depends on your philosophy, data
  availability, and/or analysis capabilities
When is it a shortage?

 “Economic Demand” model –

 When the total number of providers
 available and willing to work at a
 specific wage is smaller than the total
 number of providers that employers or
 clients want to hire at that wage.
When is it a shortage?

 “Need” model –

 When the total number of providers
 available is smaller than the total
 number of providers needed to meet
 the healthcare needs of the population.
                  Forecasting the future

 By the time you have current supply data
 and current demand data in hand, it is
 already out of date.
    It tells you where you have been.


 Forecasting is the “Holy Grail” of workforce
 planning.
    It tells you where you are headed – maybe.
       Methods of forecasting supply

 Historical trends
 Manpower to population ratios
 Econometric (“through-put”) models that
 examine all supply inputs and outputs
       Methods of forecasting demand

 Population ratio methods
 Service targets / standards
 Analysis of service utilization by population
  groups
 Econometric & simulation methods
            Bringing it together

The end result is a graph or table that
predicts, in a general way, what can be
expected if nothing changes.
                                     100

                                     80


Repetition is            Thousands
                                     60

                                     40


important!                           20

                                      0

                                     -20

                                     -40
                                           2000    2005    2010    2015    2020
                RN Supply                  62427   69509   73428   74546   74396
                Excess or Shortage         629     931     -2046   -8868   -17924
                RN Demand                  61798   68578   75474   83414   92320
                    Overview

 Much to do at the beginning
 Success is heavily dependent on strong
  collaboration among stakeholders
 Long-term gains include:
  Technology   upgrades for some boards
  Better operational and administrative efficiency

  A better informed legislature

  A factual basis for policy and spending decisions

  Regular updates of progress toward policy goals
 Questions?




Thank you.

Questions?

				
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posted:2/28/2010
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