Data Sources
Data sources include the Centers for Medicare and Medicaid Services’ (CMS) National Plan and Provider Enumeration System (NPPES). The CMS NPPES assigns a National Provider Identifier Standard (NPI) number to healthcare providers for identification in HIPAA-compliant administrative and financial transactions. When applying for an NPI number, providers select a Health Care Provider Taxonomy code that best describes their specialization. NPPES data are updated on a monthly basis, but individual records are only updated when a provider logs onto the system and makes changes.
HealthLandscape completed the data processing for the CMS NPPES data and the AMA Health Workforce Explorer currently uses NPPES data accessed in May 2018. Data processing involved geocoding providers’ best available practice address by matching these addresses with a privately maintained and licensed address database. Once longitude and latitude location attributes were applied to the address data, they were joined to U.S. Census geography files for geographic boundary identifiers.
Data sources also include the AMA Masterfile. According to the AMA:
“Established by the American Medical Association (AMA) in 1906, the AMA Physician Masterfile was initially developed as a record keeping device supporting membership and mailing activities. Since then, the AMA Physician Masterfile has expanded to include significant education, training and professional certification information on virtually all Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) in the United States, Puerto Rico, Virgin Islands and certain Pacific Islands. The AMA Physician Masterfile includes current and historical data for more than 1.4 million physicians, residents and medical students in the United States. This figure includes approximately 449,000 graduates of foreign medical schools who reside in the United States and who have met the educational and credentialing requirements necessary for recognition. A record is established when individuals enter medical schools accredited by the Liaison Committee on Medical Education (LCME), or in the case of international medical graduates (IMGs), upon entry into a post-graduate residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME)… Masterfile records are never removed even in the case of a physician's death.”[1]
The AMA is constantly working to update their data in the Masterfile through physician surveys and the collection of missing values through a variety of other sources.
HealthLandscape completed the data processing for AMA Masterfile data, and the AMA Health Workforce Mapper currently uses Masterfile data accessed in July 2018. Data processing involved geocoding providers’ best available practice address by matching these addresses with a privately maintained and licensed address database. Once longitude and latitude location attributes were applied to the address data, they were joined to U.S. Census geography files for geographic boundary identifiers.
Data Definitions
Physician Practice Type (PP) Filters (AMA, July 2018)
Physicians self-report their present practice type in the Masterfile. The filter options for present practice type are direct patient care, resident, administration, medical teaching, medical research, non-patient care, and no classification.
Physician Employment (PE) Filters (AMA, July 2018)
Physicians self-report their type of present employment in the Masterfile. The filter options for present employment are self-employed solo practice, two physician practice – full or part owner, other – patient care, locum tenens, group practice, HMO, medical school, non-government hospital, city/county/state government hospital, city/county/state other than hospital, federal government-hospital army, federal government-hospital navy, federal government-hospital air force, federal government-hospital (U.S. Public Health Service), veterans affairs, other federal agency, other-non-patient care, and no classification. Over 200,000 physicians were designated as having “no classification” in the July 2018 Masterfile.
Population per Provider Filter (AMA, July 2018, and/or CMS NPPES May 2018; 2010 U.S. Census)
This filter displays the ratio of state or county population as reported by the 2010 U.S. Census divided by number of healthcare providers in the selected categories within the state or county.
Population 2010 (2010 U.S. Census)
State or county population.
Population Density (per sq mi) (2010 U.S. Census, prepared by Esri)
State or county population divided by area of state or county in square miles.
Percent Population over 65 (2010 U.S. Census, prepared by HealthLandscape)
Percentage of state or county population age 65 or older.
Percent Population under 18 (2010 U.S. Census, prepared by HealthLandscape)
Percentage of state or county population age 18 or younger.
Total Providers (AMA Masterfile, July 2018, and/or CMS NPPES, May 2018, geocoded for the best available practice address and prepared by HealthLandscape)
Total number of providers for all physician and non-physician specialties selected at the state or county level.
Population per Provider Ratio (AMA Masterfile, July 2018, and/or CMS NPPES, May 2018; 2010 U.S. Census, prepared by HealthLandscape)
Ratio of total number of providers for all physician and non-physician specialty selections within a state or county to state or county population as reported by the 2010 U.S. Census.