Opportunities and challenges in supply-side simulation: physician-based models

Abstract

Objective: To provide a conceptual framework and to assess the availability of empirical data for supply-side microsimulation modeling in the context of health care.

Data sources: Multiple secondary data sources, including the American Community Survey, Health Tracking Physician Survey, and SK&A physician database.

Study design: We apply our conceptual framework to one entity in the health care market-physicians-and identify, assess, and compare data available for physician-based simulation models.

Principal findings: Our conceptual framework describes three broad types of data required for supply-side microsimulation modeling. Our assessment of available data for modeling physician behavior suggests broad comparability across various sources on several dimensions and highlights the need for significant integration of data across multiple sources to provide a platform adequate for modeling. A growing literature provides potential estimates for use as behavioral parameters that could serve as the models' engines. Sources of data for simulation modeling that account for the complex organizational and financial relationships among physicians and other supply-side entities are limited.

Conclusions: A key challenge for supply-side microsimulation modeling is optimally combining available data to harness their collective power. Several possibilities also exist for novel data collection. These have the potential to serve as catalysts for the next generation of supply-side-focused simulation models to inform health policy.

Figure 1

Estimated Distribution of Physicians by Region (2010): Comparison across Three Data Sources

Figure 2

Percentage of Primary Care Physicians Accepting Any Medicaid Patients: By Census Division