Physician staffing ratios in staff-model HMOs: a cautionary tale.

Predictions of imminent large physician surpluses stem from two observations: rapid increases in the proportion of Americans in managed care plans, and the relatively lean physician staffing ratios reported for health maintenance organizations (HMOs). We use internal data from two large, mature staff-model HMOs to determine precise specialty-specific physician staffing ratios, to see whether these HMOs use fewer physicians than the fee-for-service sector uses. The two HMOs provided the equivalent of 180 physicians per 100,000 enrollees, which is near the national average and far above figures that typically are reported in the literature. Thus, caution regarding current workforce predictions is warranted.