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Abstract
Objective: This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025.
Methods: A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform.
Results: The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act.
Conclusions: In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.
GLOSSARY
- AAN=
- American Academy of Neurology;
- ACS=
- American Community Survey;
- AMA=
- American Medical Association;
- BRFSS=
- Behavioral Risk Factor Surveillance System;
- CDC=
- Centers for Disease Control and Prevention;
- FTE=
- full-time equivalent;
- ICD-9=
- International Classification of Diseases, Ninth Revision;
- MEPS=
- Medical Expenditure Panel Survey;
- MGMA=
- Medical Group Management Association;
- NNHS=
- National Nursing Home Survey;
- NRMP=
- National Residency Match Program;
- PPACA=
- Patient Protection and Affordable Care Act
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received February 1, 2013.
- Accepted in final form March 29, 2013.
- © 2013 American Academy of Neurology
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