Kentucky legislators are looking to the University of Kentucky to improve the healthcare workforce across the state.
UK HealthCare hosted a legislative panel to discuss health issues in the commonwealth at Kroger Field on Wednesday, Oct. 16. The panel featured Rep. Kim Moser, Sen. Stephen Meredith, Rep Samara Heavrin, Sen. Donald Douglas, Sen. Amanda Bledsoe and Sen. Julie Adams.
Most conversations pointed to the inadequate healthcare workforce across Kentucky as the main barrier to improving overall state health.
Sen. Douglas said the issue is easy to see: “There’s simply not enough health care providers.”
As of July 2024, 107 of Kentucky’s 120 counties are classified as healthcare professionals shortage areas, meaning there are 3,500 or more patients for each provider in the county.
Sen. Douglas said healthcare deserts are a result of private practice doctors being unable to compete with large medical corporations. Unable to keep enough patients to stay in business, private doctors left Kentucky’s rural areas, he said, pushing the supply burden onto the university.
He emphasized the importance that smaller hospitals feel the university is a partner, not a competitor.
Rep. Moser said the university and legislators must work together to create incentives that keep medical school graduates practicing in the state.
In 2023, 42% of UK college of medicine graduates stayed in Kentucky to start their medical career as residents. That was actually a historic increase, with only 25-30% of graduates staying in the state from 2017-2018.
“We tend to export a lot of positions, and that is exactly the opposite of what you should be doing,” Moser said. “We really need to look at all methods of keeping students here.”
Kentucky doesn’t just need more physicians, it needs more physicians in rural areas. Around 40% of the state’s population lives in rural parts of the state, but only 17% of primary care physicians practice in those places – a statistic Sen. Douglas cited during the panel.
Physicians don’t practice in rural areas because of the wage gap, Sen. Meredith said.
“Why would anyone choose to go to the rural community, knowing you make 25-30% less than your urban counterparts? Until we address that basic issue, we’re not going to be successful addressing the main question,” he said.
Earlier this year, the state passed Senate Bill 280 to help address that very issue. The law infuses more money into community hospitals by requiring the Department for Medicaid Services to give additional payments to hospitals, reducing the payment gap between Medicaid reimbursements and what private insurance would pay.
That gives hospitals more funds to expand programming and better serve their populations.
The panel agreed that rural areas are also lacking adequate treatment and services for substance abuse disorder, but the way to fix that problem was up for debate.
Rep. Moser said a good starting point would be to provide general psych, child psych and substance use disorder treatment treatment training to every primary care physician across the state – which she suggested UK help facilitate.
Sen. Douglas said people with substance abuse disorder need to be held accountable for their actions, but also need to know people care about their recovery.
Substance abuse disorder is a symptom of a larger issue, Sen. Meredith said, and the state will not make progress until steps are taken to bring people above the poverty line.
“I’m critical of our state government because we’ve never had a comprehensive plan to address poverty. We’ll throw out 1,000 different things and hope it sticks, but it won’t,” he said.
The UK Board of Trustees will take the legislators perspective into account over the next two days as they head into the annual healthcare retreat, where they will hear from experts on the top health issues facing the state and make recommendations to the university president.
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