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Research ArticleOriginal Research

Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in Virginia

Alison N. Huffstetler, Roy T. Sabo, Martin Lavallee, Ben Webel, Paulette Lail Kashiri, Jacquelyn Britz, Mark Carrozza, Michael Topmiller, Elizabeth R. Wolf, Beth A. Bortz, Ashley M. Edwards and Alex H. Krist
The Annals of Family Medicine September 2022, 20 (5) 446-451; DOI: https://doi.org/10.1370/afm.2854
Alison N. Huffstetler
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD
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  • For correspondence: alison.huffstetler@vcuhealth.org
Roy T. Sabo
2Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
PhD
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Martin Lavallee
2Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
PhD
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Ben Webel
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
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Paulette Lail Kashiri
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MPH
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Jacquelyn Britz
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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Mark Carrozza
3Health Landscape, Cincinnati, Ohio
MA
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Michael Topmiller
3Health Landscape, Cincinnati, Ohio
PhD
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Elizabeth R. Wolf
4Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia
MD
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Beth A. Bortz
5Virginia Center for Health Innovation, Richmond, Virginia
MPP
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Ashley M. Edwards
5Virginia Center for Health Innovation, Richmond, Virginia
MHDS
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Alex H. Krist
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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  • Figure 1.
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    Figure 1.

    Distribution of family medicine physicians and pediatricians by annual number of wellness visits.

    Note: Estimated annual total number of wellness visits for each physician. Blue dashed line denotes 10–wellness visit threshold. The bimodal distribution, with large right skew, indicates that most family physicians and pediatricians had more than 200 wellness visits per year, but a small proportion had fewer than 10 per year.

  • Figure 2.
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    Figure 2.

    Multistep method for identifying the active primary care workforce in Virginia, 2019.

    DO = doctor of osteopathic medicine; MD = doctor of medicine.

    a Primary care designation required either family medicine speciality or another specialty with ≥10 wellness visit codes for the year.

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    Figure 3.

    Venn diagram for identifying the 5,899 members of Virginia’s active primary care workforce in 2019.

    DO = doctor of osteopathic medicine; MD = doctor of medicine; VA-APCD = Virginia All-Payer Claims Database.

    Notes: Diagram based on all active clinicians in Virginia in 2019 (as determined from ≥1 claim in VA-APCD database). Top left (blue) includes 25,332 clinicians who held a Virginia license. Top right (orange) includes 147,577 physicians who had an MD or DO degree. Bottom center (gray) includes 366 clinicians likely serving in a primary care capacity as ascertained from wellness visit claims, but who did not hold a Virginia license and did not have an MD or DO degree.

Tables

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    Table 1.

    Virginia’s Active Physician Workforce, Total and Primary Care, 2015-2019

    Year and WorkforceFamily MedicineInternal MedicinePediatricsObstetrics and GynecologyOther SpecialtiesAll
    2015
    Total, No.2,9425,2731,7921,0559,20220,264
    Primary care, No. (%)2,942 (100.0)  1,141 (21.6)1,011 (56.4)    735 (69.7)      31 (0.3)  5,860 (28.9)
    2016
    Total, No.2,9485,2641,7561,0259,09420,087
    Primary care, No. (%)2,948 (100.0)  1,153 (21.9)1,016 (57.9)    723 (70.5)      41 (0.5)  5,881 (29.3)
    2017
    Total, No.2,9465,3081,7871,0389,11620,195
    Primary care, No. (%)2,946 (100.0)  1,128 (21.2)1,021 (57.1)    720 (69.4)      32 (0.4)  5,847 (29.0)
    2018
    Total, No.3,0605,4901,7941,0549,39420,792
    Primary care, No. (%)3,060 (100.0)  1,112 (20.3)1,009 (56.2)    713 (67.6)      27 (0.3)  5,921 (28.5)
    2019
    Total, No.3,0895,5211,8351,0609,47120,976
    Primary care, No. (%)3,089 (100.0)1,093 (19.8)   991 (54.0)    697 (65.7)      29 (0.3)  5,899 (28.1)
    • Note: Primary care workforce was defined as physicians in family medicine specialty or physicians in other specialties having at least 10 wellness visits annually.

Additional Files

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  • SUPPLEMENTAL DATA IN PDF FILE BELOW

    Supplemental Table 1. NUCC Classification Categories
    Supplemental Table 2. Taxonomy Codes
    Supplemental Table 3. Procedure Codes for Wellness Visits

    • Huffstetler_Supp.pdf
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The Annals of Family Medicine: 20 (5)
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Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in Virginia
Alison N. Huffstetler, Roy T. Sabo, Martin Lavallee, Ben Webel, Paulette Lail Kashiri, Jacquelyn Britz, Mark Carrozza, Michael Topmiller, Elizabeth R. Wolf, Beth A. Bortz, Ashley M. Edwards, Alex H. Krist
The Annals of Family Medicine Sep 2022, 20 (5) 446-451; DOI: 10.1370/afm.2854

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Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in Virginia
Alison N. Huffstetler, Roy T. Sabo, Martin Lavallee, Ben Webel, Paulette Lail Kashiri, Jacquelyn Britz, Mark Carrozza, Michael Topmiller, Elizabeth R. Wolf, Beth A. Bortz, Ashley M. Edwards, Alex H. Krist
The Annals of Family Medicine Sep 2022, 20 (5) 446-451; DOI: 10.1370/afm.2854
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