Principal Research Analyst
According to the Rural Health Information Hub, Kansas has 82 critical access hospitals, 175 rural health clinics, 42 federally qualified health center sites located outside of urbanized areas, and 28 short term hospitals located outside of urbanized areas. Additionally, the Kansas Hospital Association reports there are 122 community hospitals throughout the state. The Kansas Hospital Association also reports 75 of these hospitals are in danger of closing due to operating at a financial loss. These hospitals continue to face a shortage of health care workers, which has been exacerbated by the COVID-19 pandemic. This article describes the reasons for that shortage and the State’s response to it.
Defining the Health Workforce
According to the Census Bureau’s 2019 American Community Survey, there were 22 million workers in the health care industry, one of the largest and fastest-growing sectors in the United States that accounts for 14 percent of all U.S. workers. The Center for Health Workforce Studies notes the health workforce refers to all of the people who deliver or assist in the delivery of health services, or help operate health care facilities. This includes:
- Health care professionals working inside the health care sector, such as in hospitals;
- Health care professionals working outside the health care sector, such as in schools or for insurance companies; and
- Health care professionals working in a private office.
Although the health care sector has seen growth in employment, the sector is expected to increase by 12 percent by 2029. However, the COVID-19 pandemic has impacted the health workforce and expanded the needs of the sector. In Kansas, this burden is greater due to the shortage of physicians, services, and hospitals across the state.
Shortage of Health Care Workers
In Kansas, there is and will likely continue to be a shortage of physicians due to location and the aging population of Kansas physicians, which has only been exacerbated by the COVID-19 pandemic. According to the Kansas Health Institute (KHI), the southeast and southwest parts of the state have fewer primary care physicians per resident in comparison to the other areas throughout the state. While these areas also have a smaller population, the fewer number of primary care physicians provides residents with fewer options for adequate service and access dependent on insurance qualifications.
In respect to age, 15.6 percent of primary care physicians indicated they were 65 years of age or older in a 2019 Kansas State Board of Healing Arts survey. When reviewing the age distribution of primary care physicians in Kansas by region, KHI reports 42.2 percent of physicians from the southeast region are 55 years of age or older and, in southwest region, that number is 45.2 percent. KHI notes innovative practices such as rural rotations, job shadowing programs that promote health care work to students in rural areas, student loan repayment programs, and other incentives that would attract students in the health care field to stay or come to Kansas, can assist in providing the workforce necessary for Kansas residents in future years.
Responses to the Shortage
The Rural Health Information Hub notes, to expand services to more individuals in need of care, telemedicine is becoming an increasingly popular form of health care service. In all areas of Kansas, but especially in the rural parts of the state, telemedicine can provide residents with access to increased options for care. Telemedicine takes away the location barrier that some face by not having a health care facility in close proximity or, in cases of specialized needs, allows individuals to receive the care they need without the risk of passing along an illness.
Although telemedicine is becoming more popular, access to broadband must be considered in expanding services and opportunities throughout the entire state.
Recent Kansas Law
Effective May 6, 2021, Senate Sub. for HB 2208 enacts the Rural Emergency Hospital Act (Act) and creates a category of licensure to enable certain Kansas hospitals to become licensed as rural emergency hospitals and receive federal health care reimbursement under that designation. The bill requires benefits coverage for services provided by rural emergency hospitals if covered when performed by a general hospital or critical access hospital.
The bill also establishes the Rural Hospital Innovation Grant Program (Program), administered by the Secretary of Health and Environment for the purpose of strengthening and improving the health care system, increasing access to health care services in eligible counties, and helping communities achieve optimal health via transitional assistance.
The Secretary may award a Rural Hospital Innovation Grant (grant) to a county that applies in accordance with the provisions of the bill. The bill allows the Secretary to award a grant only if the state moneys to be awarded in the grant have been matched by private stakeholders, including hospital foundations or other organizations, on a basis of $2 of private stakeholder moneys for every $1 of state moneys.
The bill establishes the Rural Hospital Innovation Grant Fund (Fund), administered by the Secretary. The bill requires the Director of the Budget to certify and determine on June 15, 2021, the unencumbered federal funds received by the State that may be used to award the grants. An aggregate amount equal to $10.0 million in available special revenue funds was to be transferred to the Fund on July 1, 2021. If the aggregate certified special revenue funds were less than $10.0 million, the bill requires the difference between $10.0 million and the amount certified to be transferred from the State General Fund to the Fund on July 1, 2021.
The Program sunsets July 1, 2025.