Oregon faces two problems in its efforts to educate and train a sufficient health care workforce – high debt for students and the difficulty recruiting providers to practice in underserved and rural communities – at a time when demand on the health care system will soon increase significantly. To help address this situation, Oregon Health & Science University (OHSU) is proposing the Scholars for a Healthy Oregon initiative, or SB 2.
High tuition creates challenges for students who graduate with large debt burdens and wish to pursue practice in underserved or rural areas after graduation. Some students feel deterred from even applying to a health care education program because the expected debt after graduation makes their career of choice seem out of reach. Oregon needs more students in the health professions overall and needs to find innovative ways, such as SB 2, to promote better geographic distribution of the health care workforce.
“This program is designed to be a recruitment tool for qualified students that may be debt averse and think a health care program is out of their reach,” said OHSU President Joe Robertson, MD, MBA. Dr. Robertson will testify on SB 2 before the Senate Health Care and Human Services Committee today at 3 P.M. in Hearing Room A of the State Capitol.
SB 2 would pay the entire cost of tuition and fees for (up to) 40 students in exchange for their commitment to working after graduation in Oregon’s underserved or rural communities. The program is for Oregonians only, and would give preference to first generation students, those from a regional university such as Eastern Oregon University, Southern Oregon University, Western Oregon University, Oregon Institute of Technology, and/or those who represent a diverse or rural background.
Students accepted to OHSU’s medical, dental, nurse practitioner, certified registered nurse anesthetist and physician assistant (PA) programs would be eligible to apply for one of the Scholars for a Healthy Oregon slots. Upon completion of their training, these students would be expected to serve Oregon by working in full-time practice at a site designated as a critical needs area – with a requirement to see patients regardless of the ability to pay. The length of the required commitment for each individual will be equal to the length in years of their degree program plus one additional year. For example, a PA student’s program lasts two years, so the student would be required to serve for three years in one of these communities.
Oregon will enroll approximately 400,000 new covered lives under Medicaid in 2014, once the federal health care law comes into full effect. Expanded coverage will exacerbate an already existing geographic distribution problem among health providers. In 2010 only 10% of Oregon’s licensed physicians were actively practicing in rural areas, where 37% of the population resides. In 2012 the Oregon Office of Rural Health found that 59 of the state’s 105 rural service areas have unmet health care workforce needs. This is true for all provider categories — whether dentists, nurses, physician assistants, nurse practitioners, or physicians.
“Research shows that students who are from a rural area are six times more likely to want to return to that area,” said Robertson. “We also know that we need more people to practice within underserved metropolitan areas where there are significant health disparities among different populations.”