Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage

Policy Analysis Examines State Scope-of-Practice Laws and Payment Reforms to Increase Productivity as Possible Options to Expand Access to Primary Care Services

Media Advisory
Dec. 20, 2011

Alwyn Cassil (202) 264-3484 or

WASHINGTON , DC—While there’s little debate about a growing primary care workforce shortage in the United States, it’s less clear whether existing workforce policies—such as educational loan forgiveness or scholarships and higher payment rates—can boost the supply of practitioners quickly enough, according to a new Policy Analysis from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

Written by researchers at the Center for Studying Health System Change (HSC), the policy analysis examines whether  “policy makers may want to consider ways to increase the productivity of primary care providers and accelerate primary care workforce expansion by, for example, examining how changes in state scope-of-practice policies might increase the supply of non-physician practitioners.”

According to the policy analysis, “Most efforts to improve access to primary care services center on increasing the supply of practitioners through training, educational loan forgiveness or scholarships, credentialing, and higher payment rates. The 2010 Patient Protection and Affordable Care Act includes many provisions promoting these strategies. While existing, longer-term efforts to boost the primary care workforce are necessary, they may be insufficient for some time because a meaningful increase in practitioners will take decades.”

Collectively, an estimated 400,000 practitioners, including physicians, advanced practice nurses (APNs) and physician assistants, provide primary care in the United States. Primary care physicians are typically categorized as those specializing in family medicine, pediatrics or internal medicine.

Most national studies indicate that the supply of primary care practitioners is growing but not fast enough to keep pace with demand.  For example, the Health Resources and Services Administration (HRSA) estimates an additional 17,722 primary care practitioners are already needed in shortage areas across the country to meet a target of one provider for every 2,000 patients. Likewise, other research indicates that another 35,000 to 44,000 adult primary care providers may be needed by 2025 to care for the nation’s aging population.

The policy analysis examines two other possible approaches to increase primary care capacity—expanding state scope-of-practice policies and adopting payment policies that foster increased productivity of primary care practitioners through team-based care.

The Policy Analysis—Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage—is available online at and was written by Emily R. Carrier, M.D., M.S.C.I., an HSC senior researcher; Tracy Yee, Ph.D., an HSC researcher; and Lucy Stark, an HSC health research assistant.

### ###

The National Institute for Health Care Reform contracts with the Washington, D.C.-based Center for Studying Health System Change to conduct high-quality, objective research and policy analyses of the organization, financing and delivery of health care in the United States. The 501(c)(3) nonprofit, nonpartisan Institute was created by the International Union, UAW; Chrysler Group LLC; Ford Motor Company; and General Motors to help inform policy makers and other decision-makers about options to expand access to high-quality, affordable health care to all Americans.

*** ***

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is affiliated with Mathematica Policy Research.