Supply and Distribution of the Primary Care Workforce in Rural America: A State-Level Analysis


Chronic and sometimes severe shortages of primary care providers in rural areas of the U.S. have challenged rural communities for decades. Primary care shortages especially threaten health and health care in rural communities in part because rural populations depend on primary care providers in ways that urban populations do not. Rural primary care providers deliver a wider range of medical services than their urban counterparts, coordinate care that must be obtained in other locations, and have an essential role in connecting patients to specialty services that are unavailable locally.

The geographic maldistribution of primary care providers across rural areas creates particularly acute shortages in some regions and some types of rural areas, while other rural areas are relatively well supplied. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S. It used 2019 primary care provider data from National Plan and Provider Enumeration System linked to county-level Urban Influence Codes and 2019 Claritas population data to calculate provider-to-population ratios for each provider type in all U.S. non-metropolitan counties. It compared supply between metropolitan, micropolitan, and non-core counties for each provider types. Findings are presented in a series of individual state level data briefs. Maldistribution of primary care providers continues to exacerbate primary care provider shortages in some rural areas, especially in more remote non-core counties.

WWAMI Rural Health Research Center
Eric Larson, Holly Andrilla, Lisa Garberson