Arkansas doctors expect more demand with new law

Posted: June 22, 2013 at 2:05 p.m.

LITTLE ROCK — Some health care professionals fear there won't be enough primary care professionals to meet demand next year as newly insured Arkansans gain coverage under the federal health care law.

"The underlying purpose of the (Affordable Care Act) is to make health care more accessible to more people," said Paul Cunningham, executive vice president of the Arkansas Hospital Association. "But as there is more demand for services, that will create more demand on a supply of practitioners to provide those services."

Across the country, attempts to address the provider gap have taken on increased urgency ahead of the law's full implementation Jan. 1, but many of the potential solutions face a backlash from influential groups or will take years to bear fruit.

Nearly one in five Americans already lives in a region designated as having a shortage of primary care physicians, and the number of doctors entering the field isn't expected to keep pace with demand.

Here in Arkansas, where insurance companies plan to sell their policies to more than 500,000 residents through an online marketplace created under the federal health care law, there is a shortage of primary health care professionals. Demand for medical services from those providers is only expected to increase with the implementation of the federal health care law.

"Under a scenario of expanded health care coverage in 2014 through the Affordable Care Act (ACA), the available workforce is projected to not meet demand," according to an April brief from the Arkansas Center for Health Improvement.

Beyond the overall primary care practitioner shortage, doctors aren't spread evenly throughout the state.

There's a concentration of primary care clinicians — primary care physicians, advanced practice nurses and physician assistants — in central Arkansas, while there's a moderate undersupply in the northwest and northeast parts of the state and a more drastic undersupply in the southeast and southwest regions, according to the April brief from the Arkansas Center for Health Improvement.

"We have a shortage statewide. We don't have a shortage everywhere," said Craig Wilson, director of the Access to Quality Care Initiative with the ACHI. "We do have a severe mal-distribution issue."

Wilson and others say that as Arkansans, particularly those in rural areas, gain insurance, doctors and other health care professionals may have an incentive to help fill the gap for often underserved rural areas.

However, the new health care law is not seen as a silver bullet to address the doctor shortage.

"I don't think that the Affordable Care Act is going to alleviate the current and looming physician shortage," said Dr. Dan Rahn, chancellor at the University of Arkansas for Medical Sciences. "It's good for patients in providing financial access, but the limitation may now be ... health professional supply."

Arkansas is one of several states using a partnership model between the state and federal government for running its health insurance exchange.

About half of the people who will buy insurance through the exchange are doing so under a plan lawmakers approved earlier this year to purchase private insurance for low-income residents using federal Medicaid funds. The "private option" was approved as an alternative to expanding Medicaid's enrollment under the health care law.