A Methodology for Using Workforce Data to Decide Which Specialties and States to Target for Graduate Medical Education Expansion

Abstract

Objective. To outline a methodology for allocating graduate medical education (GME) training positions based on data from a workforce projection model. Data Sources. Demand for visits is derived from the Medical Expenditure Panel Survey and Census data. Physician supply, retirements, and geographic mobility are estimated using concatenated AMA Masterfiles and ABMS certification data. The number and specialization behaviors of residents are derived from the AAMC's GMETrack survey. Design. We show how the methodology could be used to allocate 3,000 new GME slots over 5 years-15,000 total positions-by state and specialty to address workforce shortages in 2026. Extraction Methods. We use the model to identify shortages for 19 types of health care services provided by 35 specialties in 50 states. Principal Findings. The new GME slots are allocated to nearly all specialties, but nine states and the District of Columbia do not receive any new positions. Conclusions. This analysis illustrates an objective, evidence-based methodology for allocating GME positions that could be used as the starting point for discussions about GME expansion or redistribution.

Supplemental Security Income enrollment and health care and social assistance employment and wages

“…Current workforce projections do not consider SSI enrollment in associated models. 2,28,29 Our results suggest that working-age SSI enrollment may be an important correlate to help understand factors associated with health care and social assistance employment and wages at the county level. Higher SSI enrollment may increase demand for health care and social assistance services from local providers as recent health care services utilization is a requirement to apply for and maintain disability benefits through the SSI program.…”

“…Current workforce projections do not consider SSI enrollment in associated models . Our results suggest that working‐age SSI enrollment may be an important correlate to help understand factors associated with health care and social assistance employment and wages at the county level.…”

The Epicenter of Effectiveness and Efficiency in Health Care Delivery: The Evolving U.S. Health Workforce

“…This paper describes a microsimulation approach to assessing primary care provider supply and demand, a departure from the more prevalent cohort‐based approaches. The paper by Fraher, Knapton, and Holmes () focuses on a seminal policy lever, General Medical Education (GME). They outline an objective, evidence‐based methodology for allocating GME training positions based on data from a workforce projection model.…”

An Integrated Primary Care Workforce Planning Toolkit at the Regional Level (Part 1): Qualitative Tools Compiled for Decision-Makers in Toronto, Canada

“…Within these systems, workers, employers and system managers are active agents with considerable vested interest in the results of health workforce plans but these aren't always aligned with one another. Planners can deploy qualitative methods that engage key stakeholders in the design, implementation, and interpretation of HWP models to enhance the political, social, and operational feasibility of workforce plans (Jansen et al, 2014;Fraher, Knapton, & Holmes, 2017;Tomblin Murphy et al, 2016).…”