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Index measures chasm between available providers and care demand

July 02, 2014

The behavioral health labor force is expected to increase by 18 percent in this decade, reaching a total of almost 980,000 workers, according to Advocates for Human Potential (AHP), a consulting firm based in Sudbury, Mass. That’s probably not going to be enough, however. According to Jeffrey Zornitsky, director of strategic initiatives at AHP, the gap between provider supply and patient demand is significant in many states.

“Our motivation for this initiative stems from widespread consensus that overall and geographically based shortages of behavioral providers exist and will be exacerbated by health reform, without reliable estimates of the inadequacy,” says Zornitsky.

AHP recently devised a Provider Availability Index (PAI), which represents the ratio of providers per 1,000 individuals diagnosed with a condition. National numbers for 2010 data show:

·         PAI for any mental illness: 13.4 providers per thousand;

·         PAI for serious mental illness: 53.4 providers per thousand; and

·         PAI for substance use disorders (SUDs): 32.1 providers per thousand.

The 2010 numbers will be used as benchmarks, and AHP expects to promote the PAI to policy makers and others who want to track or improve the behavioral health workforce. But more telling is the individual state data. For example, Nevada (10.8) and Georgia (17.3) are the two states with the largest gap in providers of substance-use treatment programs.

AHP divided the states into quartiles to determine those states most in need of resource allocation. For example, the PAI in the lowest quartile states for people with any mental illness ranges from about 6 to 10. For those with a serious mental illness in the bottom quartile, the PAI ranges from 22 to 37. And for those with a SUD in the lowest quartile states, the PAI ranges from about 11 to 25.

Comparable PAI ratios for the top quartile states are significantly higher, ranging from 70 to 125 for serious mental illness, and 42 to 70 for SUDs. With as many as 9 million additional enrollees signing up for Medicaid through June 30, 2014, nationwide, Medicaid expansion states likely will have the greatest pressure expand the supply of providers.

There are projected to be about 194,000 job openings in behavioral healthcare for the decade ending 2020, according to AHP. However, more than half of these are attributed  to “replacement demand” or professionals leaving the field for retirement or other careers, rather than job growth. In some cases, new professionals can’t find positions that pay well enough, Zornitsky says.

More online

Read more about the SUD workforce shortage here from Addiction Professional.

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