California is facing a looming health crisis – a physician shortage that could force people to forgo needed care or push them into emergency rooms for minor ailments. Last year, the University of California San Francisco released a report showing California is expected to face a statewide shortfall of 4,700 primary care providers as soon as 2025. By 2030, we will need another 4,100 providers to meet the demand.
Compounding the problem is an aging population – the graying baby boomers who will require more care. By 2030, one in five Americans will be 65 or older. Of course, physicians are among them, with retirements on the horizon. On top of that, there are simply more patients of every age as the Affordable Care Act expanded health care coverage. The Council on Graduate Medical Association, a division of the Department of Health and Human Services (HHS), recommends at least 60 primary care doctors for every 100,000 people, and closer to 80 would be better. However, some counties in California have fewer than 40. In L.A. County, the number is 56.
This should serve as a call to action for the health care industry. With all but three regions in the state falling under the minimum recommendation of primary care physicians for the population, it is time for a multifaceted intervention. It won’t be easy, as California will be competing with other states facing their own physician shortages. The Association of American Medical Colleges released a study in April showing the U.S. could see a shortage of more than 121,000 physicians by 2030.
As a health plan serving the most vulnerable populations in Los Angeles County, L.A. Care Health Plan depends on doctors working everywhere from South Los Angeles to the Antelope Valley, often in the safety net. They are providers who offer access to care regardless of a patient’s ability to pay, which includes the uninsured, Medi-Cal members, and other vulnerable people. To ensure our members will never struggle to see a primary care physician, we have launched Elevating the Safety Net, an ambitious initiative beginning with three programs.
The first is a scholarship program. L.A. Care has awarded eight four-year medical school scholarships – four to students attending UCLA and four to students attending Charles Drew University. Upon learning of the award, one student wrote, “This scholarship is life changing for my family and me.” Another responded within nine minutes of receiving the offer, saying, “I hope I’m not responding too fast, but I accept! Thank you so very much for this honor, and life-changing opportunity to graduate from medical school debt free.” It is our hope that this gratitude will result in more physicians working within the safety net.
A second grant program will provide funding to safety net clinics and provider practices so they can offer salary subsidies, sign-on bonuses, and/or relocation costs to physicians recruited to work in the facilities. It’s estimated that each new physician recruit will be able to treat up to 2,000 new patients.
The third grant program under Elevating the Safety Net supports medical school loan repayment for physicians newly recruited to work within the safety net. When surveyed, most medical students say they chose the field because they wanted to help people. But altruism takes a major hit when students leave med school with a loan payment the size of a mortgage. With that burden, it’s no wonder doctors who wanted to be primary care providers end up in a higher-paying specialty field – fields where they can more than double their pay, easing the pain of loan payments. Our initiative will erase that burden for doctors working within the safety net.
The L.A. Care Board of Governors has committed up to $31 million dollars to launch Elevating the Safety Net. Our commitment to the low-income members we serve is strong, and as a publicly-operated health plan, we are proud that we can step up and take action that will benefit our members now and in the years to come.
John Baackes is the CEO of L.A. Care Health Plan. The organization is dedicated to providing access to quality and affordable health care for Los Angeles County residents through a variety of health coverage programs, including Medicaid, L.A. Care Covered (California Health Benefit Exchange), L.A. Care Cal MediConnect Plan and PASC-SEIU Homecare Workers Health Care Plan.
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