The Virginia primary care workforce: Final results of a novel method of analysis

Background: In order to evaluate the capacity of primary care to provide comprehensive, coordinated, continuous care, a description of the primary care workforce is necessary. There have been prior efforts to describe the distribution of primary care, however, an accurate and timely description of which clinicians are in what location has been lacking. Further, the scope of care provided has not been fully explored. This research aimed to describe the primary care workforce distribution and specialty across the state of Virginia. Methods: The Virginia All-Payers Claims Database (APCD) and National Plan and Provider Enumeration System (NPPES) we queried. We identified all physicians (MD and DO) through NPPES and then cross referenced these clinicians with the APCD to identify those with an active claim in 2018. The NPPES was used to identify the physician specialty. Results: In 2018, there were 20,779 active physicians, of which 3,054 were family medicine, 1,794 were pediatricians, 1, 079 were OB/Gyns, and 5,247 were internal medicine or general medicine clinicians. The number of clinicians remained relatively stable between 2015-2018. Physicians were also categorized by ambulatory, inpatient, and mixed care. Discussion: This is the first evaluation that identifies clinician characteristics by using both active practice and NPPES taxonomy of type of clinicians. This will provide insight into the way care is provided across the state and establishes a foundation for evaluation of continuous care, comprehensive care and coordinated care in the future. As claims can be used to identify individuals over the course of time, it will be possible to identify scope, continuity and additional characteristics of clinicians. Additionally, we hope to identify advanced practice providers and their scope of care as well as clinicians migration and evolution during their career.