In some parts of the US, it seems no matter where you look, you can find a Walgreens, CVS, or Rite Aid. But many neighborhoods still lack convenient access to a pharmacy.

These areas are called “pharmacy deserts,” but unlike actual deserts, they’re all over the US. More than 40% of all US counties are considered pharmacy deserts, per research from drug marketplace GoodRx.

Pharmacy deserts disproportionately affect Black and Hispanic/Latino neighborhoods, too. A 2021 study from the University of Southern California (USC) found there are “persistently fewer pharmacies” in Black and Hispanic/Latino neighborhoods compared to white or diverse neighborhoods.

Defining a pharmacy desert. There are multiple ways to define a pharmacy desert, according to Dima Qato, a senior fellow at USC’s Schaeffer Center for Health Policy and Economics. Her team identifies pharmacy deserts using metrics like location, economic status, and vehicle ownership.

If most people in an urban neighborhood live more than a mile away from the nearest pharmacy, it’s a desert. If that neighborhood is low income and few households own a car, then that threshold drops to half a mile, said Qato.

A pharmacy desert in the suburbs occurs when most people live more than two miles away from the nearest pharmacy, or a half mile if most residents don’t own a car, said Qato. And a pharmacy desert in a rural area constitutes people living farther than 10 miles from the nearest pharmacy.

The financials behind a pharmacy desert. When it comes to the financials behind pharmacy closures, “it may seem complicated, but actually isn’t,” said Qato.

Pharmacy benefit managers (PBMs) play a big role in pharmacy closures. They create pharmacy networks for insurers, which direct patients to visit specific pharmacies.

Keep reading here.—MA

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Thousands of doctors are expected to reach retirement age in the next three years, and their replacements won’t be physicians. Instead, physician assistants (PAs) and nurse practitioners (NPs) will increasingly provide primary care services, according to a report from consulting firm Mercer.

By 2026, 21% of family medicine, pediatric, and obstetrics and gynecology physicians—or about 32,000 doctors—will be 65 or older, and Mercer anticipates about 23,000 physicians will leave the profession permanently. At the same time, demand for primary care physicians is expected to grow 4%, the report found.

PAs and NPs—also called advanced practice providers (APPs) or physician extenders—are highly trained medical professionals. To become a PA, you have to have both a bachelor’s and a master’s, some clinical work experience, pass the Physician Assistant National Certifying Exam, and then apply to get licensed in your state (you know, easy peasy). It takes seven to nine years to go through that process, compared to 11+ years to become an MD.

To become an NP, you must have both a bachelor’s and a master’s in nursing, become a registered nurse, and pass a national NP board certification exam. It takes between six to eight years to become an NP.

Compared to physicians, PAs and NPs are “considerably younger professions with less than half the retirement risk,” the Mercer report stated. Roughly 40,000 PAs and NPs join the workforce annually.

“We’re certainly going to see increasing demand for APPs,” David Mitchell, a partner in Mercer’s career consulting business and a specialist in the healthcare industry, told Healthcare Brew.

While most state licensing boards require a physician to oversee APPs, both PAs and NPs have the authority to do many services primary care physicians do, like seeing and diagnosing patients, ordering lab tests, and writing prescriptions, said Mitchell.

Keep reading here.—MA

Most US adults believe it’s the federal government’s responsibility to make sure that all people have healthcare coverage—but they also think that Washington officials shouldn’t get into the business of providing health insurance.

That’s the latest takeaway from Gallup’s 2022 annual health and healthcare poll. And the nuanced finding is largely on par with respondent opinions reported to the national pollster in recent years.

The findings: Almost six in 10 US adults surveyed (57%) told Gallup that the federal government should ensure healthcare coverage. A similar majority (53%) also said they prefer that the US healthcare system be based on private—not government-run—insurance.

Since 2015, more than half of the respondents have consistently said it’s the government’s responsibility to ensure healthcare coverage (and before that, from 2000–2008, this figure was steadily around 60%), according to Gallup’s trend data. Meanwhile, preference among respondents for a private insurance-based health system has hovered above 50% for much of the last decade—only dipping below that to 48% in 2017.

Respondents who identified as Democrats were more likely than those who identified as Republicans to say it’s the government’s responsibility to make sure people in the US have healthcare coverage (88% to 28%, respectively). Respondents who identified as Democrats were also more likely than their Republican counterparts to prefer a government-run healthcare system (72% to 13%, respectively).

Methodology: Gallup polled at least 1,000 adults living in all 50 states (and Washington, DC) via phone from Nov. 9–Dec. 2, 2022.—SY

Do you work in healthcare or have information about the industry that we should know? Email Shannon at [email protected]. For completely confidential conversations, ask Shannon for her number on Signal.

Stat: The US maternal mortality rate jumped 40% between 2020 and 2021, according to new data. (Time)

Quote: “It was a dead-end event, as far as we can tell.”—Kaitlin Sawatzki, a postdoctoral researcher at the Cummings School of Veterinary Medicine at Tufts University, on the avian flu spreading to seals last year (the New York Times)

Read: A Tennessee woman was warned that her pregnancy could kill her, but doctors in the state, where abortion is illegal, refused to provide her an abortion over fears of prosecution. (ProPublica)

Time well spent: Demand for healthcare is rising, and patients and providers are feeling the pinch. WellSpan Health physicians using Nuance’s DAX improved the patient experience and saw 9 more patients per month. Get the full report.*

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