Healthcare worker shortage hurts all of us

The severe need for employees has major financial implications slowing New Hampshire's economic potential

According to a December 2018 survey, community health centers have 109 clinical and nonclinical vacancies, and over 2,000 healthcare worker vacancies exist across New Hampshire, including hospitals and community mental health centers. The problem is expected to intensify as the elderly population grows larger than the workforce who can assist them. By 2030, almost one-third of Granite Staters will be over the age of 65.

New Hampshire’s shortage of healthcare workers has major financial implications for nonprofit and for-profit businesses and is slowing the state’s economic potential. Tangible costs associated with physician vacancies include salaries and fees paid to recruitment firms, lost productivity for employees involved in candidate selection, on-boarding costs, including training and credentialing new physicians, and a decrease in revenue.

These accumulative costs can be as high as $345,000 for the loss of one physician. A lack of clinicians and direct care providers limits Granite Staters’ access to services, causing a rationing of needed care and added health care costs system-wide.

Right now, the Granite State is well-positioned to invest in recruiting and retaining our healthcare workforce. A coalition of provider organizations, advocates and policy experts have been working with Democrats and Republicans to develop a bipartisan legislative proposal to secure the workforce we need to serve patients now and into the future.

Senate Bill 308 combines key policy and budget initiatives to alleviate New Hampshire’s health care workforce shortage.

SB 308 addresses an important administrative burden faced by many professions: New Hampshire’s criminal background check system. While surrounding New England states allow for online background checks, New Hampshire does not. It is common for interviewing staff to have to wait 15 days for a candidate’s application to be reviewed at a facility in Concord. SB 308 supports the Department of Safety in implementing an online background check system.

Another contributing factor to the workforce shortage is that we are losing qualified candidates to surrounding states.

New Hampshire has one Family Medicine Residency Program with eight slots, and half of its graduates move across state lines after graduation to start their careers. By investing in scholarships with service commitments, career advancement programs, and training programs (such as the Nurse Practitioner Fellowship Program in Newmarket), SB 308 is designed to equip New Hampshire with opportunities that will incentivize healthcare professionals to stay and work here.

New Hampshire pays among the lowest Medicaid reimbursement rates in the nation, and most Medicaid providers have not received a rate increase in many years. Low reimbursement rates affect healthcare organizations’ ability to pay competitive wages, which contributes to provider turnover and reduces timely access to health care services. SB 308 proposes a modest Medicaid rate increase of 5 percent in fiscal year 2020 and 7 percent in 2021 for all Medicaid services. The increase to all Medicaid rates included in this bill is a much-needed investment in our healthcare workforce.

The State Loan Repayment Program (SLRP) is considered the No. 1 tool to recruit providers in high-need areas like rural New Hampshire, where it is more difficult to draw clinicians. The availability of student loan funds is essential for primary healthcare providers, including community health centers, to compete with providers in the greater Boston area and fill open positions.

SB 308 includes a substantial investment in SLRP, which allows clinicians to repay their student loans in exchange for a three-year service commitment. Currently, two-thirds of clinicians participating in SLRP practice in rural New Hampshire.

SB 308 contains numerous solutions to better position the Granite State to meet the current and future needs of our residents. We hope that you will join the NH Health Care Workforce Coalition in supporting SB 308’s systemic approach to addressing our health care workforce crisis.

Tess Stack Kuenning is president and CEO of the Bi-State Primary Care Association, which represents 15 New Hampshire community health centers.

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