Kentucky Considers Enhancing Physician Recruitment

Jun 23, 2013

FRANKFORT, Ky. -- Health care reforms could force Kentucky to strengthen physician recruitment in medically underserved areas to accommodate more than 600,000 additional people in the state who soon will be covered by Medicaid or private insurance.

The planned expansion of Kentucky's Medicaid program coupled with a push to help the uninsured obtain health coverage through the Kentucky Health Benefit Exchange is expected to exacerbate a longstanding shortage of physicians in many rural communities.

The Kentucky Cabinet for Health and Family Services is considering several proposals to deal with the problem, including bringing more international medical graduates into rural communities and expanding loan-forgiveness programs for doctors who set up practices in underserved areas.

Those were among recommendations made by Deloitte Consulting, a technology firm that's helping to set up the Kentucky Health Benefit Exchange.

Other options recommended by Deloitte include creating support programs for small medical practices in underserved communities, increasing Medicaid reimbursement for rural areas, evaluating medical malpractice caps and enhancing programs aimed at recruiting and retaining physicians.

"Issues around access to health care and workforce capacity have been a concern for a number of years in Kentucky," said Gwenda Bond, spokeswoman for the Cabinet for Health and Family Services. "The Cabinet has undertaken a study to help us better understand those issues as the system prepares to meet the needs of the 640,000 currently uninsured Kentuckians who will finally have the quality health care coverage they deserve."

Deloitte recently completed a review that found Kentucky would have needed to find ways to increase the number of doctors and other medical professionals even if it didn't expand medical coverage to more than 600,000 new patients.

The review found that the state needs 3,790 additional physicians, including primary care doctors and specialists, plus 612 more dentists, 5,635 more registered nurses, 296 more physician assistants and 269 more optometrists to meet current demand.

Gov. Steve Beshear announced earlier this month that he will expand the state's Medicaid program to cover an additional 300,000 people, most of them the working poor who don't now have insurance coverage. In addition, Beshear has ordered the creation of the health benefit exchange to help more than 300,000 others get insurance coverage.

Kentucky's Medicaid program already provides medical coverage to some 800,000 residents. Under the Affordable Care Act, Kentucky had the option of expanding coverage to some 308,000 additional people with incomes up to 138 percent of the federal poverty level. That means individuals making up to $15,860 a year would be eligible as would families of four making up to $32,499.

Washington will pick up the entire cost of the expansion for the first three years, and 90 percent over the longer haul.

Expanded Medicaid will be available starting Jan. 1, and uninsured people can start signing up this fall. So far, 21 states plus Washington, D.C., have accepted the expansion, while 14 states have turned it down. Another 15 states are still weighing options.