Lacey Associates Presentation

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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
 through regular assessment of
  workforce supply and demand.
                   Mission Implications

 Improve upon current data collection efforts – if
     “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
 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
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

 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
    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
 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.


Repetition is            Thousands


important!                           20



                                           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

 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

Thank you.


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