• Annals of family medicine · Sep 2022

    Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in Virginia.

    • Alison N Huffstetler, Roy T Sabo, Martin Lavallee, Ben Webel, Paulette Lail Kashiri, Jacquelyn Britz, Mark Carrozza, Michael Topmiller, Elizabeth R Wolf, Beth A Bortz, Ashley M Edwards, and Alex H Krist.
    • Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia alison.huffstetler@vcuhealth.org.
    • Ann Fam Med. 2022 Sep 1; 20 (5): 446451446-451.

    PurposePrimary care is the foundation of the health care workforce and the only part that extends life and improves health equity. Previous research on the geographic and specialty distribution of physicians has relied on the American Medical Association's Masterfile, but these data have limitations that overestimate the workforce.MethodsWe present a pragmatic, systematic, and more accurate method for identifying primary care physicians using the National Plan and Provider Enumeration System (NPPES) and the Virginia All-Payer Claims Database (VA-APCD). Between 2015 and 2019, we identified all Virginia physicians and their specialty through the NPPES. Active physicians were defined by at least 1 claim in the VA-APCD. Specialty was determined hierarchically by the NPPES. Wellness visits were used to identify non-family medicine physicians who were providing primary care.ResultsIn 2019, there were 20,976 active physicians in Virginia, of whom 5,899 (28.1%) were classified as providing primary care. Of this primary care physician workforce, 52.4% were family medicine physicians; the remaining were internal medicine physicians (18.5%), pediatricians (16.8%), obstetricians and gynecologists (11.8%), and other specialists (0.5%). Over 5 years, the counts and relative percentages of the workforce made up by primary care physicians remained relatively stable.ConclusionsOur novel method of identifying active physicians with a primary care scope provides a realistic size of the primary care workforce in Virginia, smaller than some previous estimates. Although the method should be expanded to include advanced practice clinicians and to further delineate the scope of practice, this simple approach can be used by policy makers, payers, and planners to ensure adequate primary care capacity.© 2022 Annals of Family Medicine, Inc.

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