Physicians in These States May Struggle Most in 2014

In 2014, millions of Americans are anticipated to gain health insurance through the Affordable Care Act. What does that mean for physicians?

On the one hand, it means job security. You’ll experience higher demand for your services - especially if you’re a primary-care provider - and typically that would translate to higher reimbursements.

But as other healthcare reform initiatives stress improved quality of patient care at reduced cost, you’ll feel pressure not only to accommodate more patients, but also to reach quality and cost targets. That’s a lot to deal with.

Some physicians may have a harder time adjusting to the new changes than others - and it may all come down to location.

For instance, physicians in the least-physician dense states will have the hardest time fitting new patients into their schedules. Most likely, they are already stretched thin for services.

In addition, those physicians practicing in states which currently have the highest percentage of uninsured individuals will, naturally, experience the highest influx of new patients.

According to our 2011 Best States to Practice Report (which includes rankings of states based on physician density) and the 2011 Gallup-Healthways Well-Being Index, which tracks healthcare information (including insured population data), the four states with the worst density/uninsured combination are:

1. Texas: With a 27.2 percent uninsured population rate, the Lone Star state is also one of the least physician dense.

2. Mississippi: It has a 24.5 percent uninsured population, and it’s the third least physician-dense state.

3. Oklahoma: With 22.5 percent of its population uninsured, it’s the second least physician-dense state.

4. Arkansas: 21 percent of its population is uninsured., and it’s the seventh least physician-dense state.

States with the best combination in terms of physician density and uninsured population are:

1. Massachusetts: Massachusetts is the most physician-dense state in the country. And no surprise here, only 5.3 percent of its population is uninsured given its recent state-based reforms.

2. Maryland: The second densest state, its uninsured rate is 11.4 percent.

3. Connecticut: With 10.3 percent uninsured, it is the fourth most physician-dense state.

4. Vermont: The sixth most physician dense state, its uninsured rate is 9.2 percent.

Still, if you’re a physician practicing in one of the less attractive states (according to the data), don’t panic.

David Howard, an associate professor in Emory University's Department of Health, Policy, and Management, acknowledges that the relationship between physician supply to patient population varies widely across the country.

Still, he told Physicians Practice via e-mail, the concern about increased demand is “somewhat overblown.”

“I'm not aware of evidence to suggest that waiting times are so much worse in Alabama or other areas with relatively low physicians per capita compared to areas with a lot of supply,” he said, adding that Massachusetts’ health reform was not associated with large increases in patient wait times.

In addition, Howard said, the Obama administration has relaxed rules limiting the use of nurse practitioners and physician assistants. “That should ease the transition under health reform somewhat.”