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A Study of Dentist Workforce Supply Estimates, Trends, and Capacity to Provide Service

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A Study of Dentist Workforce Supply Estimates, Trends, and Capacity to Provide Service Utah’s Dentist Workforce: A study of dentist workforce supply estimates, trends, and capacity to provide service Utah Medical Education Council December 2002 Utah’s Dentist Workforce: A study of dentist workforce supply estimates, trends, and capacity to provide service Prepared by Matt Horstmann, Health Policy Analyst Utah Medical Education Council December 2002 Acknowledgements Utah’s Dentist Workforce: A study of dentist workforce supply estimates, trends, and capacity to provide service was funded by the Utah Medical Education Council. The data in this report was made available through the professional efforts of various state, federal, and private organizations. Special appreciation is given to the following individuals for their expertise and assistance. Steven Steed, DDS Susan Aldous, RDH State Dental Director Dental Access Consultant Utah Department of Health Utah Department of Health Lynn Powell, DDS Wayne Cottam, DMD, MS Assistant Dean, School of Medicine Dental Director University of Utah School of Medicine Community Health Centers Inc. Kathleen Hardy, MPA Don Hawley, DDS, MPA Research Analyst Program Coordinator Utah Office of Primary Care Utah Department of Health, and Rural Health Division of Health Care Financing Further Acknowledgement and appreciation is given to the staff and consulting members of the Utah Medical Education Council: Gar Elison, M.L.S. David Squire, M.P.A Executive Director Chief Financial Officer Brenda Silverman, Ph.D. Julie Olsen Staff Consultant Administrative Assistant Dan Bergantz Jennifer Ha Research Analyst Research Analyst Clint Elison Mike Bronson Research Analyst Research Analyst Boyd Chappell Research Analyst This report can be reproduced and distributed without permission. Board Members of the Medical Education Council Chair W. Lavon Day, M.S. A. Lorris Betz, M.D., Ph.D. Rural Educator & State Advisor Senior Vice President for Health Sciences Technology Student Association & Dean, School of Medicine Southeastern Utah Economic CEO, University of Utah Health System Development Council David J. Bjorkman, M.D., S.M. John W. Robinson, M.D. Senior Associate Dean President, Utah Healthcare Institute School of Medicine Residency Director, St. Marks University of Utah Family Medicine Residency Gaylen Bunker, M.B.A., C.P.A Michael J. Stapely, M.P.A. Director of Business Studies President and CEO Westminster College Deseret Mutual Benefits Administrator William L. Hamilton, M.D., M.B.A. Medical Director, Aileen Clyde Intermountain Health Care Educator & Former Member of Urban Central Region State Board of Regent Citizen Appointee The report can be made available in support of additional research or policy analysis concerning Utah’s dentist workforce or other healthcare issues. For more information contact: Utah Medical Education Council 230 South 500 East Suite 550 Salt Lake City, UT 84102-2062 Phone: (801) 526-4550 Fax: (801) 526-4551 www.medicaled.state.ut.us Table of Contents Section Page Executive Summary i Part 1 – Workforce Report A. Introduction 1 B. Utah Dentist-to-Population Ratios 1 C. Factors Affecting Dentist Population and Utilization 4 D. Factors Impacting Dental Education 5 E. Attrition and Migration Rates 6 F. Labor Demand 8 G. Patient Demographics 9 H. Population Characteristics 10 I. Health Professional Shortage Areas 11 J. Government Programs Affecting Access to Dental Care 12 K. Medicaid and Dentistry 15 L. Need for Further Study 16 M. Conclusions 16 Part 2 – Appendices A. Map of Dental Health Professional Shortage Areas 19 B. Dental HPSA Process and Criteria 20 C. State Medicaid Expenditure per resident 22 Table of Contents Section Page Part 2 – Appendices (Continued…) D. Projected Dentist Supply Estimates 23 E. Population Projections for County and State 24 Acronym and Abbreviation Reference Guide ADA: American Dental Association ADEA: American Dental Education Association BYU: Brigham Young University CHEC: Child Health Evaluation and Care CHIP: Children’s Health Insurance Program DHPSA: Dental Health Professional Shortage Area DOPL: Department of Professional Licensing DWS: Department of Workforce Services FTE: Full-Time Equivalency GAO: Government Accounting Office GOPB: Governor’s Office of Planning and Budget HPSA: Health Professional Shortage Area PIE: Professional Insurance Exchange PHS: Public Health Service SDA: Service Delivery Area SDB: Shortage Designation Branch UDA: Utah Dental Association UDOH: Utah Department of Health UMEC: Utah Medical Education Council VA: Veteran’s Affairs Executive Summary ince 1997, the Utah Medical Education Council (UMEC) has provided objective policy relevant analyses and information to evaluate the service capacity of Utah’s healthcare workforce, both estimated and projected. The UMEC makes recommendations to the state governor and legislature in S support of strategies needed to ensure that Utah has a healthcare workforce able to meet the needs of its growing and diverse population. BACKGROUND In 2002, the Utah Medical Education Council compiled private, state, and federal data of Utah licensed dentists, to assess the supply, distribution, and characteristics of the state’s dentist workforce. Various initiatives and programs designed to increase access to dental care were then considered, as they related to their potential effect on the total dentist population. The primary sources of data compiled for this report were obtained from the American Dental Association, Utah Dental Association, Department of Occupational and Professional Licensing, Utah Department of Workforce Services, United States Department of Health and Human Services Health Resources and Services Administration, Utah Department of Healthcare Financing, Utah Governor’s Office of Planning and Budget, and the Utah Office of Primary Care and Rural Health. Various state and federal studies were used to supplement these primary sources. It is important to note the dates of the data referenced and the source(s) of the material, in order to ensure accurate interpretation and representation of the figures presented. This report provides the following information: 1. The estimated 2002 Utah dentist-to-population ratio; 2. Factors affecting dentist supply and utilization; 3. National trends in dental education and the impact on workforce supply; 4. Factors affecting the dentist workforce: attrition and migration rates; 5. State labor demand for dentists; 6. Patient and population characteristics; 7. Dental Health Professional Shortage Designation Areas; 8. Federal and State programs affecting access to dental care; 9. Medicaid enrollees, reimbursement rates, and dentist participation in the program. FINDINGS The major findings of the study are presented below. Dentist supply and distribution • In Utah, the 2002 dentist workforce ratio is 61.74 dentists per 100,000 population. • There are an estimated 1,417 professionally active dentists in Utah. • The number of dentists per 100,000 population varies by county, with 17 of Utah’s 29 counties experiencing provider ratios below the state’s 61.74 average. • Only 2.8 % of dentists licensed to practice in Utah are female. This constitutes the lowest ratio in the nation. The national average of women in professional dental practice is 14.4%. i • 91% of the Utah dentist workforce is in private practice. • Of the total 1,286 active private practitioners in Utah, 1064 are in general practice, 36 specialize in Oral & Maxillofacial surgery, 26 are Endodontists, 105 specialize in Orthodontics, 28 specialize in Pediatric Dentistry, 19 specialize in Periodontics, and 9 are Prosthodontists. • All 29 counties in Utah have been designated as a Health Professional Shortage Area (HPSA), but only 5 of the counties have HPSA designations based upon a shortage of dentists. 3.2% of the state’s population reside in those 5 counties. • Utah attracts 1 dental school graduate for every 36,851 residents, compared to the national average of 1 graduate to every 67,158 residents. • Under current conditions, Utah will not begin to experience a shortage of dentists until the year 2009. • 79.2% of Utah’s dentists practice in counties where 76.1% of the population live. Dentist participation in Medicaid • 6.5% of the Utah dentist workforce treat over two-thirds of the Medicaid patients. • 20% of dentists accepting Medicaid patients submitted fewer than 6 claims in an entire year. • 24 of Utah’s 29 counties were designated Dental Health Professional Shortage Areas because of the lack of dentists participating in Medicaid. • Only 56,012 out of 222,360 Medicaid enrollees (for the year 2000) received dental service(s). The percentage of Medicaid enrollees experiencing the greatest access difficulties to dental care reside in four counties; Beaver, Garfield, San Juan, & Wasatch. Dentist workforce retirement activity • 15% of the dentists licensed to practice in Utah are under age 35, 49% are between the ages of 35-54, and 35% are age 55+. • 2.78% of Utah dentists leave the workforce annually due to retirement. • An estimated 41.17 dentists will retire in the year 2003, while Utah continues to attract a 5 year average of 71.6 new dentists • The dentist workforce retirement rate is projected to remain constant over the next thirty years, with the exception of a 20 percent increase in numbers retired between the years 2011-2015 due to a surge in retiring baby-boomers. SURVEY RECOMMENDATIONS The existing dental workforce data used in the preparation of this report provided a valuable baseline of information. Additional knowledge would enhance the dentist workforce
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