July | August 2017






Opening Borders to Health Care Professionals

By Crady deGolian, Director of CSG’s National Center for Interstate Compacts
Population growth, aging baby boomers and a dramatic rise in the number of insured Americans resulting from the Patient Protection and Affordable Care Act are stressing America’s health care system like never before. Demand for care is increasing dramatically, but access to a variety of health professionals has remained largely static.
Research published by the “Annals of Family Medicine” estimates the United States will need an additional 52,000 primary care physicians by 2025 to keep up with growing demands on the health care system. Licensing medical professionals in multiple states could help ease the access burden, but only 6 percent of doctors are licensed in three or more states, according to research from the Federation of State Medical Boards. A similar trend can be found across other health care professions.
One possible solution may be an increased emphasis on license portability through a series of health care licensing compacts. Such agreements could allow providers in several health professions to significantly increase access to care in rural and hard-to-serve areas, which in turn has the potential to reduce costs for patients, states and the federal government. Such agreements also could allow providers to take advantage of improving technologies and offer more telehealth services.
“In an increasingly global world, interstate licensing agreements provide a means to ensure access to high-quality care, while promoting continuity between patients and health care providers,” said Nancy Kirsch, director of the physical therapy program at Rutgers University.
In addition to increasing access and promoting portability, licensing compacts ensure state regulatory agencies can maintain their licensing and disciplinary authority, while providing an effective means to protect patient safety.
“First and foremost, the goal of these projects is to protect patients,” said Dia Gainor, executive director of the National Association of State EMS Officials. “The way that the public gets protected is to have everyone meet and exceed a level of certification before they interact with patients.”
Each state and U.S. territory separately licenses medical professionals. That means practitioners, regardless of discipline, seeking a license in more than one state must go through each individual state’s licensing process. This process could be streamlined through the use of interstate compacts.
Interstate compacts are unique tools that encourage multistate cooperation and innovative policy solutions while asserting and preserving state sovereignty. The Council of State Governments’ National Center for Interstate Compacts is working with several groups in determining the feasibility of a compact related to their particular profession.
These licensing compacts in various stages of development will be featured during a session to be convened Aug. 13 at CSG’s Annual Meeting in Anchorage, Alaska. During the session, attendees will learn about interstate compacts broadly, as well as hear about some of CSG’s ongoing compact work in the area of health care licensing.
Rick Masters has consulted with The Council of State Governments’ National Center for Interstate Compacts for about 10 years. He will talk about the medical licensing compacts at the conference.
“I cannot recall a time where there was so much overlap between our ongoing projects,” he said. “That is a testament to the strength of the compact mechanism, but it also creates a need for education and awareness on the part of legislators, legislative staff and policymakers. This session represents the first step in that process.”


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