Member and Provider Services Unit

Ret: Access to Care: # of primary care providers (PCPs) per 1500 Medicaid members

7.13 SFQ3 2023

Definition
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Notes on Methodology
  • The target for this measure is 1 primary care provider per 1500 members per county in Vermont.

Partners
  • DVHA Data Unit
  • Provider Community
  • DVHA Clinical Unit
  • Vermont Department of Health
  • Gainwell Technologies
Story Behind the Curve

This measure is important because Vermont is experiencing a high number of Primary Care Providers (PCPs) retiring and it is important for members to access PCPs within a 30-mile radius of their home.

Primary Care is big issue in Vermont. Many states across the country have a need to attract more PCPs, but Vermont's situation has an additional twist: a sizeable number of the state's PCPs are expected to retire in the next few years. Currently in 2020, there is a need for 69 PCPs in Vermont. Due to member complaints regarding lack of PCPs, it is important to monitor the PCP population in each county in Vermont. Almost 30 percent of PCPs in the state of Vermont are over the age of 60 or nearing retirement age. When they retire, there likely will not be enough new PCPs to replace them. When a provider shortage occurs, patients are unable to access the care they need. They might have trouble finding a provider to book an appointment with, or once an appointment is obtained patients might face long office wait times. These issues adversely impact patient satisfaction and can also have negative health consequences.

The Member & Provider Services (MPS) Unit's Provider Team monitors this measure in collaboration with the Vermont Department of Health: https://www.healthvermont.gov/systems/health-professionals/shortages-and-designations.

The trendline shows that the overall availability of PCPs is remaining steady.  The break-out grid shows more PCPs exist in more populated counties while there is a shortage of PCPs in the more rural counties.

Narrative last updated: 12/04/2020

Strategy

As of 01/01/21, Vermont is allowing physician assistants (PAs) to function as PCPs. There are over 360 PAs in Vermont. This should help alleviate some of the shortage of PCPs.

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy