FAQs

A: There are many sources of health workforce data. Some sources have known and documented limitations. It is important to understand the data’s purpose and how they are collected, verified, and updated.

There are 2 reports that describe multiple data sources:

• The Health Workforce Analysis Guide, 2016 Edition lists selected federal, nonfederal, and state data sources, and has a brief section on general data limitations.
• The Compendium of Federal Data Sources to Support Health Workforce Analysis (2017) contains information on individual data sets such as NPPES, MEPS, and NHANES. Some of the sources included in the Compendium are freely available. Others require an application, data use agreement, and/or payment.

Selected federal sources:

The Bureau of Labor Statistics (BLS) is a commonly used federal data source included in the compendium. The BLS tracks employment by industry and occupations, projects future employment, houses the Current Population Survey, and provides other employment statistics. A known limitation is that the BLS Occupational Employment Statistics data count jobs, not workers, and excludes workers who are self-employed, unemployed, or in certain industries. Professions with a large number of self-employed workers, such as physicians and dentists, may be underestimated, while professions with workers that work 2 or more part-time jobs, such as dental hygienists, may be overestimated. The Current Population Survey, which surveys households, is another commonly-used dataset from BLS that is used to estimate health workforce statistics.

The Area Health Resource File (AHRF) is a publicly available dataset that aggregates data from disparate data sources. It contains county-level and state-level data on healthcare workers and other demographic and health-related variables. Some variables based on data from the American Dental Association, the American Hospital Association and the American Medical Association are subject to copyright restrictions.

Selected nonfederal sources:

Professional associations, such as the American Medical Association (AMA), the American Dental Association (ADA), and the American Hospital Association (AHA) conduct their own surveys and maintain databases (eg, “Masterfiles”) for administrative and analytic uses. These data sources are often proprietary and available for purchase under strict data use agreements.

SK&A maintains databases on physicians and other healthcare practitioners. They claim that the lists are verified every 6 months and updated monthly, and that mailing lists are guaranteed 100% deliverable.

Another nonfederal data source is Kaiser Family Foundation State Health Facts. Like the AHRF, this source reports aggregated data on providers, service use, and other useful health-related variables obtained from outside resources.

State sources:

States may or may not collect their own workforce-related data. The State Health Workforce Data Collection Inventory lists states that collect data on health workforce supply, demand, and/or education.

A: There are multiple approaches to collecting data and data are often collected for different purposes. As a result, it is important to understand the methodology behind each dataset and its intended use in order to make valid comparisons. For example, the Bureau of Labor Statistics Occupational Employment Statistics collects data from employment surveys; the data count jobs, not workers, and they count employed, not self-employed positions. Professional association masterfiles (eg, AMA, ADA) are based on membership surveys and other sources, and data may not accurately account for professionals that are licensed and practicing in more than one state. State licensure data are self-reported through license applications and renewals, and hinge on the licensees accuracy and timeliness. The National Provider and Plan Enumeration System (NPPES) is a registry of providers that submit Medicare and Medicaid claims; this is an administrative database where the billing address of the provider may not match the provider’s practice location. Health professionals are mobile, some more than others, and change jobs and locations; these moves may not be reflected accurately or in a timely manner.

A: An article by DesRoches et al (2015) compared the National Provider and Plan Enumeration System (NPPES), the American Medical Association Masterfile, and the SK&A physician file to evaluate data accuracy. The authors performed this analysis in the context of using the selected datasets for sampling frameworks and counting physicians in a given area. The authors found that while none of the files were perfect, the NPPES contained broader coverage and NPPES and SK&A data had reasonably accurate and current address information. The AMA Masterfile had lower rates of correct address information.

State licensure data are another matter. Some state medical boards require only basic information, including a mailing address for licensing correspondence. Some states collect more robust data through licensure, including multiple practice addresses, and demographic, education, and practice characteristics. Some states conduct regular surveys. States may or may not systematically verify the licensure or survey data.

Different data sources have different limitations. Before using any dataset as a sampling frame or for research, it is essential to understand the data’s purpose and how they are collected, verified, and updated.

A: Many states are already collecting health workforce data, with a customized MDS in place to collect any additional data they need for health workforce planning. Some examples of states that are already collecting an MDS include North Carolina, Virginia, New York, Indiana, and Minnesota.

For more information on which states are collecting data, visit our State Health Workforce Data Collection Inventory, or contact HWTAC.

A: There are generally 4 methods to collect health workforce data:

1. Licensure Process. Data are collected as part of the licensure process when health professionals apply for their initial license and when they renew, capturing 100% of the workforce. This is one of the most efficient and cost-effective methods to collect data. Some questions on the licensure forms may be mandatory, while others are optional. The organizational structure of the licensing boards will present different opportunities and barriers to data collection. Examples: North Carolina, South Carolina, Virginia

2. Surveys. Data are collected through surveys, either in conjunction with the licensure process or as a separate effort. This method requires more staff time and money. Response rates may vary, but this is a good option if health workforce questions cannot be included directly on the licensure forms. Examples: New York, Wisconsin

3. Continuous Monitoring. Data collection begins with a list of all licensees in one or more professions. From there, states track individuals through surveys, news clipping services, and other methods to determine practice status, practice setting, and other characteristics. This method can be costly, but it may provide more up-to-date information. Examples: Iowa, Nebraska

4. Secondary Data Sources. Secondary data sources can also be used to enumerate the workforce in a specific state. These data sources include the National Provider Identification (NPI) file, the American Medical Association (AMA) Physician Masterfile, the US Bureau of Labor Statistics, and the Census Bureau’s American Community Survey, as well as state professional associations. Additionally, all-payer claims databases can be used to enumerate the health workforce in select states, but there are significant limitations.