NURSE MANAGED HEALTH CENTERS AND PATIENT-CENTERED MEDICAL HOMES COULD MITIGATE EXPECTED PRIMARY CARE PHYSICIAN SHORTAGE
Des Moines University
There has been an enormous focus on the impending increase in baby boomers approaching the year 2025 and the predicted shortage of primary care providers. This focus has only increased with the implications the Affordable Care Act has created through its provisions of increased insurance coverage for the uninsured. The numbers that are being predicted as shortfalls of health care providers may be exaggerated under many estimates or under-represented in others. The authors in, “Nurse Managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortages,” analyzed the impact of two emerging models of care—the patient-centered medical home and the nurse –managed health center. These are two models which use a provider mix that is richer in nurse practitioners and physician assistants than today’s predominant models of care delivery. The research found that these new models could have an impact on the projected shortages of primary care positions in certain circumstances.
The article, “Nurse-Managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortage,” examines the projected shortages of primary care physicians that are estimated to occur in 2025. This shortage as was discussed by Shi and Singh in the text, “Delivering Health Care in America pages 132-135 6th Edition. The authors, Auerbach, Chen, Friedberg, Reid, Lau, Buerharm, and Mehrota state on page 5, “projections indicate that if nothing changes we will face a large shortage of primary care doctors and potential surpluses of physician assistants and nurse practitioners by 2025.” (2013)This study analyzes the production model of anticipated physicians, nurse practitioners, and physician assistants for the future. It compares the status quo of current output trends around medicine with two new models that revolve around the medical home staffed by an interdisciplinary team, and a nurse managed health center. Both models are shown through this study to impact the provision of health care in a positive way. Specifically, a shortage of primary care physicians given a number of possible forecasts. These solutions may be things to consider in looking toward the future trends associated with the outcomes of more insured individuals and the need for primary care services. Throughout this paper the main points of how this analysis was conducted, and the major conclusions arrived at will be reviewed. The implications for future healthcare options will also be discussed. It was an appealing article as it has real application for delivery of care in assisted living, home care and nursing homes for the aging long-term care population.
This study utilized a systematic review of previous information, published studies and data that was available. The authors methodically reviewed areas of estimated provider supply and demand, estimated production functions, and surplus shortage analysis each using a number variations and scenario planning that could change the outcomes obtained. They were able to use data, surveys and public literature reviews to access relevant studies and research on estimation and projections for Physicians, Nurse Practitioners, and Physician Assistants. PURPOSE OF REVIEW
The purpose as stated in the article on page 1 was to, “show how projections would change under different scenarios involving greater or lesser adoption of new models of care delivery and depending on how models are staffed.” (Auerbach, Chen, Friedberg, Reid, Lau, Beurhaus, and Mehrotra 2013) This review has meaning beyond the desire to show how projections would change and staffing shortages could be mitigated. Current trends show an...
References: Auerbach, D. I., Chen, P. G., Friedberg, M. W., Reid, R., Lau, C., Buerhaus, P. I., et al. (2013). Nurse-Managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortage. Health Affairs, 32(11), 1933-1941.
Shi, L., & Singh, D. A. (2015). Delivering Health Care in America: A Systems Approach (6th ed.). Boston: Jones and Bartlett.
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