National Center for the Analysis of
Healthcare Data
Ann K. Peton, MPH
Director
National Center for the Analysis of Healthcare
Data (NCAHD)

2

 Established in May 2007
 Founding Project – AMA/AOA Scope of Practice
Partnership
 Established unique methodology to create national
healthcare workforce datasets from state licensure
 2008-2010 – major project with Health Resources
Services Administration to provide national data for
the Area Resource File
 2010 Established our own national advisory board
made up on 15 nationally recognized healthcare
workforce leaders
National Center for the Analysis of
Healthcare Data (NCAHD)

Mission and Objectives
The Center’s focus is to provide data mapping
and spatial analysis of either your data and/or our
data warehouse of the nation’s most complete
collection of physician and non-physician data, along
with other demographic, socio-economic, and
political data in support of your advocacy, medical
education planning/expansion, research, and other
healthcare workforce planning
National Center for the Analysis of
Healthcare Data (NCAHD)

Allopathic and Osteopathic Physician data with
Specialty information
Non-Physician Provider Data:
Mid-levels: Nurse Practitioners, Physician Assistant
13 Non-Physician Providers: Nurse Anesthetist,
Certified Nurse Midwives, Certified Nurse Specialist,
Podiatrist, Speech Language Pathologist, Audiologist,
Psychologists, Optometrists, Pharmacists,
Chiropractors, Physical Therapists, Dentists, Dental
Hygienists
National Center for the Analysis of
Healthcare Data (NCAHD)

Past/Current Clients (over 200 projects and/or clients in the last eight
years)
• National physicians and non-physician associations (e.g.
American Osteopathic Association, American Medical
Association, Physician Assistant Education Association, etc.)
• Colleges of Medicine (KCUMB-COM, AT Still University,
Vanderbilt, University of Chicago, etc.) and Area Health
Education Associations (state and regional programs)
• Healthcare research institutes and rural health associations (e.g.
NRHA, Robert Graham Center, etc.)
• Hospital Associations, state workforce boards, state provider
associations, state agencies (e.g.Tennessee Hospital Association/
Rural Partnership, West Virginia Rural Health Association)
National Center for the Analysis of
Healthcare Data (NCAHD)

• Data Research – aside from our enhanced state licensure
(ESL), we find and process many other state and national
demographic, socio-economic, health indicators, etc. to
support research, proposal development, planning, etc.
• Mapping and Spatial Analysis
• Alumni Tracking – validate school’s existing alumni and/or
find missing alumni; perform analysis on specialty,
proximity to rural and underserved, etc.
• Training on GIS/mapping
• Healthcare workforce economic impact analysis – for
medical schools and entire primary care workforce
• Time Series mapping/data subscription service (Future)
• Internet Mapping Portal Development – current projects
with Tennessee, West Virginia, Arkansas and New York and
the American Osteopathic Association
NCAHD’s Products and Services

State Comparative Provider Analysis of Rural to Urban Practice Patterns
Physicians, Nurse Practitioner and Physician Assistants 2008-2014
State Total %Rural %Urban Total %Rural %Urban Total %Rural %Urban Total Rural Urban Total Rural Urban Total Rural Urban Total Rural Urban
Overall
Change Rural Urban
Overall
Change Rural Urban
Alabama 10,823 5% 95% 554 7% 93% 2,581 4% 96% 8% 5% 95% 74% 7% 93% 64% 4% 96% 6% 10% 1% 71% 133% 59% 61% 55% 56%
Alaska 1,870 23% 77% 443 30% 70% 582 23% 77% 14% 29% 71% 25% 31% 69% 17% 39% 61% 5% 23% 3% 15% 15% 15% 8% 20% 5%
Arizona 15,045 3% 97% 1,854 3% 97% 3,274 3% 97% 7% -3% 103% 27% -10% 110% 16% -12% 112% 4% 64% 0% 22% 7% 22% 12% 18% 10%
Arkansas 6,146 7% 93% 247 9% 91% 1,519 8% 92% 7% 7% 93% 90% 9% 91% 62% 8% 92% 4% 13% -1% 86% 56% 82% 59% 46% 58%
California 114,708 1% 99% 8,944 1% 99% 18,294 2% 98% 17% 1% 99% 28% 1% 99% 28% 2% 98% 15% 24% 15% 26% 33% 26% 26% 28% 25%
Colorado 14,469 8% 92% 2,088 6% 94% 2,867 8% 92% 10% 6% 94% 37% 2% 98% 6% -6% 106% 3% 26% 0% 28% 22% 27% -1% 8% -2%
Connecticut 12,694 1% 99% 1,707 1% 99% 3,579 0% 100% 5% 1% 99% 25% 1% 99% 30% 0% 100% 5% 40% 5% 24% 27% 24% 29% 63% 29%
Delaware 2,455 2% 98% 268 2% 98% 598 2% 98% 6% 2% 98% 35% 2% 98% 60% 2% 98% 3% 138% -1% 32% 481% 26% 57% 16% 56%
Florida 50,348 4% 96% 6,488 1% 100% 14,289 1% 99% 9% -3% 103% 34% -2% 102% 34% -2% 102% 7% 29% 6% 7% 29% 6% 46% 24% 46%
Georgia 23,213 2% 98% 3,880 2% 98% 4,448 4% 96% 11% -19% 119% 38% -5% 105% 38% -18% 118% 8% 6% 4% 35% 23% 30% 17% 11% 15%
Idaho 3,132 9% 91% 570 8% 92% 650 9% 91% 4% 4% 96% 6% -41% 141% 43% -8% 108% -4% 48% -13% -2% 11% -8% 33% 15% 29%
Illinois 37,706 2% 98% 2,760 2% 98% 8,377 5% 95% 26% 2% 98% 34% 2% 98% 47% 5% 95% 25% 29% 24% 33% 13% 34% 46% 41% 45%
Indiana 15,485 3% 97% 966 4% 96% 4,035 3% 97% 5% 3% 97% 59% 4% 96% 53% 3% 97% 4% 13% 1% 57% 14% 57% 51% 62% 49%
Iowa 7,249 24% 76% 809 24% 76% 1,143 24% 76% 7% -1% 101% 17% -9% 109% 12% -25% 125% 3% 16% -5% 13% 11% 12% 7% 6% 6%
Kansas 6,015 6% 94% 903 7% 93% 2,220 17% 83% -2% 6% 94% 23% 7% 93% 57% 17% 83% -4% -3% -6% 21% 22% 21% 55% 37% 57%
Kentucy 11,114 11% 89% 1,015 13% 87% 3,495 13% 87% 10% 11% 89% 30% 13% 87% 69% 13% 87% 9% 38% -1% 28% 30% 21% 67% 72% 61%
Louisiana 11,395 3% 97% 746 3% 97% 2,973 3% 97% 6% 3% 97% 61% 3% 97% 80% 3% 97% 3% 24% -1% 57% 53% 53% 76% 96% 71%
Maine 4,320 24% 76% 524 26% 74% 1,041 24% 76% 8% -10% 110% 183% 21% 79% 15% 14% 86% 7% 7% 5% 178% 127% 204% 13% 20% 9%
Maryland 21,382 1% 99% 2,268 1% 99% 2,886 1% 99% 8% -1% 101% 22% -1% 101% 10% -5% 105% 3% 56% 2% 17% 29% 16% 5% 22% 5%
Massachusetts 27,276 1% 99% 2,417 1% 99% 7,078 1% 99% 1% 1% 99% 42% 1% 99% 31% 1% 99% 0% 63% 0% 41% 32% 41% 30% 19% 30%
Michigan 29,826 4% 96% 4,235 5% 95% 4,899 6% 94% 4% 4% 96% 34% 5% 95% 46% 6% 94% 5% 0% 4% 35% 9% 36% 47% 48% 46%
Minnesota 14,683 10% 90% 1,447 10% 90% 2,620 10% 90% 8% 1% 99% 31% 2% 98% 27% 7% 93% 4% 10% 2% 26% 16% 26% 23% 27% 21%
Mississippi 6,161 9% 91% 114 10% 90% 2,502 5% 95% 14% 9% 91% 68% 10% 90% 74% 5% 95% 12% 39% 1% 65% 108% 47% 72% 75% 64%
Missouri 15,075 5% 95% 629 6% 94% 3,980 6% 94% -3% 5% 95% 17% 6% 94% 54% 6% 94% -4% 2% -7% 15% -3% 14% 52% 44% 52%
Montana 2,675 33% 67% 449 29% 71% 471 33% 67% 14% 21% 79% 38% 21% 79% -1% -1% -1% 7% 13% 4% 30% 25% 31% -3% 0% -5%
Nebraska 4,374 13% 87% 874 21% 79% 992 13% 87% 5% -8% 108% 32% 21% 79% 34% 10% 90% -1% 1% -4% 25% 41% 20% 27% 33% 24%
Nevada 5,379 1% 99% 501 2% 98% 722 1% 99% 8% -2% 102% 14% -3% 103% 29% -3% 103% -1% 85% -3% 5% 73% 3% 18% 15% 16%
New Hampshire 4,089 14% 86% 535 8% 92% 275 14% 86% 7% -2% 102% 22% -2% 102% 80% 11% 89% 6% -9% 9% 21% -12% 25% 78% 44% 85%
New Mexico 4,876 8% 92% 550 8% 92% 1,005 8% 92% 6% 2% 98% 19% 17% 83% 30% 10% 90% -1% -4% -1% 11% 45% 9% 21% 32% 20%
New York 70,916 2% 98% 9,980 2% 98% 12,463 4% 96% 6% 2% 98% 23% 2% 98% 1% 4% 96% 5% -11% 5% 22% 26% 21% 0% 6% -1%
North Carolina 22,704 3% 97% 4,886 5% 95% 5,093 5% 95% 3% 3% 97% 42% 5% 95% 54% 5% 95% 0% -7% -2% 37% 30% 35% 49% 46% 48%
North Dakota 1,626 28% 72% 243 29% 71% 443 28% 72% 8% 1% 99% 16% 9% 91% 34% 18% 82% -2% 10% -10% 6% 14% 1% 23% 31% 17%
Ohio 32,066 2% 98% 2,335 2% 98% 6,950 4% 96% 7% 2% 98% 35% 2% 98% 81% 4% 96% 7% 9% 6% 35% 43% 34% 81% 102% 79%
Oklahoma 8,664 6% 94% 957 15% 85% 892 16% 84% 8% -11% 111% 39% 3% 97% 346% 3% 97% 5% 332% -18% 36% 32% 34% 15% 26% 12%
Oregon 12,982 5% 95% 1,232 4% 96% 1,657 5% 95% 17% 3% 97% 68% 1% 99% -3% 79% 21% 12% 54% 9% 60% 43% 60% -7% -11% -7%
Pennsylvania 44,127 2% 98% 6,310 2% 98% 8,053 5% 95% 14% 2% 98% 58% 2% 98% 44% 5% 95% 13% 28% 11% 57% 104% 54% 43% 48% 42%
South Carolina 11,304 2% 98% 1,186 4% 96% 2,385 4% 96% 18% 2% 98% 97% 4% 96% 51% 4% 96% 14% 27% 10% 91% 174% 84% 46% 30% 44%
South Dakota 1,852 14% 86% 453 15% 85% 548 23% 77% 8% 56% 44% 13% -64% 164% 3% 19% 81% 5% 245% -22% 0% -37% 10% 56% 55% 54%
Tennessee 17,091 4% 96% 1,434 5% 95% 6,620 6% 94% 7% 4% 96% 46% 5% 95% 47% 6% 94% 5% 10% 1% 42% 41% 39% 44% 42% 41%
Texas 57,403 8% 92% 6,568 3% 97% 11,660 4% 97% 18% 37% 63% 48% -1% 101% 48% 1% 99% 14% 370% 5% 43% 17% 43% 58% 46% 57%
Utah 6,726 2% 98% 1,080 4% 96% 1,601 5% 95% 8% 2% 98% 44% 4% 96% 41% 5% 95% 3% -12% 2% 38% 14% 39% 35% -37% 39%
Vermont 2,517 29% 71% 293 33% 67% 458 41% 59% 25% 29% 71% 28% 33% 67% 60% 41% 59% 23% 17% 22% 27% 31% 21% 58% 54% 58%
Virginia 22,199 4% 96% 2,307 6% 94% 4,933 4% 96% 9% 4% 96% 49% 6% 94% 43% 4% 96% 6% 5% 3% 45% 12% 43% 39% 46% 37%
Washington 1,218 18% 82% 218 31% 69% 214 18% 82% 15% 20% 80% 35% 16% 84% 3% -14% 114% 3% 6% 1% 22% 9% 29% -7% -8% -8%
West Virginia 4,853 11% 89% 707 16% 84% 1,100 12% 88% 4% 11% 89% 45% 16% 84% 75% 12% 88% 3% 19% -8% 43% 34% 36% 73% 81% 63%
Wisconsin 13,577 7% 93% 2,050 9% 91% 3,692 12% 88% -15% 7% 93% 18% 9% 91% 42% 12% 88% -16% -18% -18% 18% 9% 17% 40% 39% 39%
Wyoming 22,203 5% 95% 2,134 4% 96% 4,051 5% 95% 18% 0% 100% 10% -19% 119% 32% 2% 98% 10% 31% 8% 2% -2% 2% 23% 49% 21%
2015 Physicians
(MDDO)
% Change in #
of Physicians
% Overall Change
in Physicians per
100,000
% Overall Change
in Nurse
Practitioners per
100,000
2015 Physician
Assistants
2015 Nurse
Practitioners
% Change in # of
Physician
Assistants
% Change in # of
Nurse
Practitioners
% Overall Change
in Physician
Assistants per
100,000

Per
100,000
Population Average Ratio
Per
100,000
Population Average Ratio
Per
100,000
Population Average Ratio
Family Medicine 28.08 1:3,561 35.54 1:2,814 26.66 1:3,750
Internal Medicine 22.86 1:4,374 13.03 1:7,672 24.73 1:4,043
Pediatrics 12.83 1:7,796 9.63 1:10,389 13.44 1:7,443
Allergy & Immunology 1.17 1:85,737 0.54 1:186,207 1.29 1:77,746
Cardiology 5.51 1:18,140 2.96 1:33,833 6.00 1:16,667
Dermatology 2.80 1:35,762 1.17 1:85,462 3.11 1:32,196
Endocrinology, Diabetes, and Metabolism 1.05 1:95,096 0.36 1:280,334 1.18 1:84,464
Gastroenterology 2.56 1:39,066 1.29 1:77,304 2.80 1:35,702
Hematology & Oncology 3.07 1:32,626 1.54 1:65,078 3.36 1:29,796
Infectious Disease 9.04 1:11,067 5.24 1:19,080 9.76 1:10,247
Nephrology 1.17 1:85,530 0.64 1:155,551 1.27 1:78,775
Neurology 3.04 1:32,913 1.71 1:58,645 3.29 1:30,374
Psychiatry 11.14 1:8,978 5.73 1:17,443 12.17 1:8,219
Rheumatology 0.38 1:262,866 0.19 1:520,620 0.42 1:240,212
Other Specialty 7.44 1:13,448 4.51 1:22,173 7.99 1:12,510
General Surgery 7.30 1:13,700 6.51 1:15,358 7.45 1:13,424
Neurological Surgery 1.34 1:74,867 0.54 1:186,207 1.49 1:67,211
Obstetrics & Gynecology 9.66 1:10,351 6.57 1:15,221 10.25 1:9,757
Ophthalmology 4.26 1:23,499 2.69 1:37,133 4.55 1:21,963
Orthopaedic Surgery 6.92 1:14,459 5.20 1:19,239 7.24 1:13,805
Plastic Surgery 1.48 1:67,412 0.58 1:172,952 1.66 1:60,391
Urology 2.36 1:42,390 1.92 1:52,168 2.44 1:40,929
Other Surgical Specialties 1.22 1:82,180 0.55 1:180,285 1.34 1:74,461
Emergency Medicine 11.07 1:9,035 7.76 1:12,881 11.70 1:8,549
Anesthesiology 10.56 1:9,473 4.75 1:21,057 11.66 1:8,574
Radiology-Diagnostic 9.76 1:10,242 5.52 1:18,112 10.57 1:9,459
Pathology-Anatomic and Clinical 3.89 1:25,718 2.20 1:45,392 4.21 1:23,757
Pediatric Cardiology 0.27 1:366,502 0.05 1:1,822,171 0.31 1:318,095
Pediatric Neurology 0.12 1:836,895 0.06 1:1,546,084 0.13 1:769,644
Other Pediatric Subspecialties 2.28 1:43,956 0.47 1:212,587 2.62 1:38,186
* Ratio's generated after all reported specialties were normalized to ACGME standard definitions and group accordingly. Individual
provider practice location relative to OMB rural and rural population was utilized to create rural and urban ratios.
Medical Specialties
Surgical Specialties
Hospital-Based
Pediatric Subspecialties
Primary Care
Created by NCAHD using National Enhanced State Licensure Data and 2015 Census Population Estimates
ACGME Specialties
National Rural Urban
2015 Physician Specialty Ratios*

2008-2012 Healthcare Workforce Shift
-60.0
-40.0
-20.0
0.0
20.0
40.0
60.0
80.0
100.0
RhodeIsland
Iowa
Utah
NewYork
NorthDakota
Washington
Missouri
NewMexico
Oregon
Hawaii
Alabama
Nevada
Montana
WestVirginia
Arkansas
Indiana
Nebraska
Colorado
Alaska
Kansas
NewJersey
SouthCarolina
SouthDakota
Georgia
Kentucky
Arizona
Tennessee
Massachusetts
Oklahoma
Louisiana
Minnesota
Ohio
NewHampshire
Michigan
Maryland
Mississippi
Virginia
Pennsylvania
Maine
Texas
Illinois
Florida
NorthCarolina
Idaho
Wisconsin
Vermont
Delaware
California
Wyoming
Connecticut
Migration of Primary Care Workforce
between Urban vs Rural per 100,000 population
from 2008 to 2012
Greater Migration
towards Urban
Greater Migration
towards Rural
28

2008-2012 Healthcare Workforce Shift
-10000
0
10000
20000
30000
40000
50000
Migration of Allied Healthcare Workforce
between Urban vs Rural from 2008 to 2012
Greater Migration
towards Urban
Greater Migration
towards Rural
29

National Healthcare Workforce Data
Collection Process

How we
Create
The
Enhanced
State
Licensure
Data
Fifteen
Healthcare
Providers
From
50 different
State
Licensure
Boards
Process
Takes
3-4 months
2 FTE

State Licensing Data Comparison

• Free public access to all of the enhanced state
licensure data
• Visualize the individual providers at a national
and regional level
• Zoom in to see state, county and zip code
aggregates of providers and demographic
information at the total number or percentage
• Users can download the data as a spreadsheet
NCAHD’s Healthcare Workforce
Mapping Portal - Features
Website: http://gis.ncahd.org

NCAHD’s Healthcare Workforce
Mapping Application
Website: http://gis.ncahd.org

27

Examples of Unique Mapping and
Analysis Service

30

Demographic Profile of
Florida’s Psychologists
National
• Total Instate Licensed Psychologists = 89,595
• % Change from 2008 = 4%
• Total in Rural Areas* = 8,478
• % of all psychologists serving rural = 10%
State Average = 17%
• Total in Mental Health Professional
Shortage Areas (HPSA) = 16,558
• % of all physicians in Mental HPSA = 19%
State Average = 30%
Florida
2010 NCAHD Enhanced State Licensure
• Total Instate Licensed Psychologists = 3,815
• % Change from 2008 = 7%
• Total/% in Rural Areas* = 148/4%
• State Rank = 44
• Total/% in Florida in Mental HPSA = 537/14%
State Rank = 34

• Data Research – aside from our enhanced state licensure (ESL), we
find and process many other state and national demographic, socio-
economic, health indicators, etc. to support research, proposal
development, planning, etc.
• Mapping and Spatial Analysis
• Alumni Tracking – validate school’s existing alumni and/or find
missing alumni; perform analysis on specialty, proximity to rural and
underserved, etc.
• Trend analysis on Physician, NP, PA and 14 other providers at the
county, state and national level
• Healthcare workforce economic impact analysis – for medical
schools and entire primary care workforce
• Future - Time Series mapping/data subscription service
• Internet Mapping Portal Development – current projects with
Tennessee and West Virginia; Ohio and Virginia in discussion phase
Current and Future Research and
Product/Services Development

Questions
Ann K. Peton, MPH
NCAHD Director
573-301-9654
apeton@vcom.vt.edu
NCAHD website: www.ncahd.org