SANTA FE, N.M. (AP) — New Mexicans could have longer waits for a doctor or specialist as demand grows for medical services because of an aging population and expanded insurance coverage under the Patient Protection and Affordable Care Act (PPACA), legislative auditors said Wednesday.
A report released by the Legislative Finance Committee said state residents could encounter growing problems of access to medical care due to the potential need of 2,000 physicians, 3,000 registered nurses and as many as 800 dentists.
Up to 172,000 uninsured New Mexicans are expected to receive medical coverage next year either through an expansion of Medicaid or a state-run health insurance exchange. More than 400,000 New Mexicans lack health care coverage.
“The number of health care professionals and their maldistribution throughout the state cannot adequately meet current demand, let alone the additional pressures brought about by the newly insured in 2014,” the report said.
“In the near term, the lack of supply will result in longer wait times to see a provider and more difficulty accessing specialists. As New Mexico’s population expands and becomes proportionately older, the state can expect even greater health care access problems.”
Auditors said “it’s unlikely that New Mexico will experience a train wreck” in 2014 but there will be a gradual deterioration of access to health care.
Auditors recommended the state take a number of steps to increase the number of health care providers, including physician assistants and nurse practitioners who can help ease the shortage of doctors.
“About half of the population is basically healthy and can be cared for by nurse practitioners and physician assistants, a professional group that can be trained more quickly and at less cost than physicians,” the report said.
However, New Mexico produces more physicians than it does nurse practitioners. From 2007 to 2011, the state’s public colleges and universities educated 234 nurse practitioners, and 263 physicians came out of the New Mexico’s medical school. There were 79 physician assistants educated during that same time.
The report said the total number of registered nurse degrees from New Mexico schools dropped from 2007 to 2011 despite the state providing $28 million to nursing programs since 2004.
Auditors suggested the state’s Medical Board should consider expand the role of physician assistants by giving them more independence to practice outside the supervision of a doctor.
Other recommendations in the report include increasing money for programs to train physicians in family medicine, expanding student loan repayment programs for physicians and reviewing licensing requirements for all health care professionals to eliminate possible barriers for recruiting more providers to New Mexico.
Auditors said New Mexico needs to change the delivery of health care so that patients with chronic illnesses, who use a greater share of medical services, get more coordinated care.
“New Mexico should shift its emphasis from sick care to wellness and prevention, thus redefining the health care workforce and delivery of health care services beyond the traditional clinical setting,” the report said.
The recruitment and training of medical professionals needs to reflect those changes in how health care is provided, auditors said.
At a committee hearing on the audit, Dr. Michael Landen, the state epidemiologist, said New Mexico needed to not only increase the number of medical providers in the state but address disparities in health care access.
Southeastern New Mexico was most lacking in health care coverage, he said. That largely rural area has the highest rate of cancer deaths but the lowest number of oncologists.
“We can’t just allow our health care resources to end up where they will, distributed where they will,” said Landen.
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