Health Workforce Analysis Survey Methodology
The MDH Health Workforce Analysis (HWA) team collects data on 17+ licensed healthcare professions, including primary care, oral health, mental health, and select other allied health professions in Minnesota. The Healthcare Workforce survey is administered at the time a provider renews his/her professional license. The data collection period for each profession coincides with the license renewal period for that profession, so each person renewing a license has the opportunity to complete the survey. Minnesota Statutes 144.051–0.052 authorize the collection of these data at the time of license renewal.
Once the data collection for a given profession is complete, analysts prepare the data for analysis, following these steps:
- Download the survey data from the web–based server.
- Remove duplicate cases. Duplicates can occur when a professional renews their license more than once within a renewal cycle.
- Prepare practice address data for geocoding. This may involve editing typos, correcting street directionals, replacing PO boxes with physical addresses, and making similar corrections to maximize the accuracy of the automated geocoding process.
- Geocode practice address data. This which identifies providers’ county, region, and Rural Urban Commuting Area (RUCA). RUCAs are an important measure of the rurality of the location in which a provider practices.
- Merge survey data with public data from the corresponding health licensing board. Licensing boards collect additional administrative data on all licensees, and this data offers a point–in–time snapshot of the entire set of actively licensed healthcare professionals. Blending the rich data from the Health Workforce survey with the administrative board data gives us the maximum amount of information about counts and characteristics of all providers within each profession.
Although administrative board data gives us a total count of the actively licensed providers within a given profession, the number of employed, Minnesota–based practitioners is always a subset of this number, as described below.
- Providers with out–of–state practice addresses. Within each profession, some share of licensees (typically between 5 and 20 percent) report out–of–state practice addresses. Often, but not always, these addresses are in states that border Minnesota. These addresses cannot be geocoded, and therefore these professionals are excluded from counts in any geographic analyses. However, some providers with out-of-state addresses may in fact be practicing in Minnesota. Some providers treat patients via telehealth; others may practice in Minnesota for part of the year; still others may work in Minnesota as well as a border state. Currently, there is no way to know with certainty how many providers with out-of-state addresses are actually treating patients in Minnesota.
- Providers with no practice address. Similarly, some smaller share of licensees (typically less than 5 percent) report no practice address at all. Often this is because they are no longer practicing. It is not uncommon for retired healthcare providers to maintain their licenses, for example. However, there may be some working professionals who simply opt not to provide a practice address. However, since these providers cannot be geocoded to a location, they too are not counted in geographic analyses.
- Retired or Unemployed Providers. Finally, a small share (typically between 1 and 8 percent) of each profession reports on the workforce survey that they do not currently hold a position related to their license. Most of these respondents indicate that they are retired, but smaller shares report that they are temporarily not working, or are unemployed and looking for work.
Since these three categories of licensees (out–of–state address / no address / not working) often overlap—and since we only have employment information on the subset of licensees who responded to the survey—it is not possible to construct an exact count of the share of actively licensed providers who are practicing in Minnesota. However, we can use these three pieces of information to estimate a rough upper bound to that number for each profession.
Defining Rural, Urban and Underserved Areas in Minnesota
Rural and Urban Areas
There are many ways to define Minnesota's rural and urban areas. One is to use the Rural and Urban Commuting Areas (RUCA) which provide an alternative method for analyzing health care workforce data by geography. The RUCA categories are based on size of the city or town and the daily commuting of the population to identify urban cores and adjacent territory economically integrated with those cores. Additional information on RUCA is available on the Rural–Urban Commuting Area Codes at the United States Department of Agriculture Economic Research Service website.Rural Urban Commuting Area Maps:
The Office of Rural Health and Primary Care also defines rural to urban areas by referring to the Metropolitan and Micropolitan Statistical Areas which use a county designation. Then, by default, defines other counties as rural if they are not in a metropolitan or micropolitan statistical area.
- Metropolitan and Micropolitan Statistical Areas Main, United States Census Bureau
- Minnesota's Metropolitan, Micropolitan and Rural Counties in Minnesota, 2017
The Office of Rural Health and Primary Care prepares applications for federal shortage area designation and maintains Minnesota maps of the Health Professional Shortage Areas and Medically Underserved Areas/Populations – HPSA and MUA/P, which are defined by the Health Resources and Services Administration.