Recruiting Providers Who Trained Abroad

With a shortage of health care providers looming, the U.S. is trying to tap foreign-trained professionals to fill the gap. There are two tactics to achieve this, as several recent articles in Fierce Healthcare point out: giving temporary visas to nurses currently living and working abroad, and creating on-ramps for foreign-trained health care professionals living in the U.S. to practice medicine again.

As Fierce Healthcare points out, these policies would not just increase the number of people practicing medicine in the U.S., they would also add more diversity and language/cultural competency skills to the current health care workforce.

A bill approved by the House of Representatives, H.R. 1933, would double the length of time that foreign-trained nurses could work in U.S. hospitals from three years to six years, although the bill allows fewer of these visas than were granted in the past. These nurses would work in areas with nursing shortages that also serve Medicare and Medicaid patients, the Fierce Healthcare article explains.

Fierce Healthcare points out that, despite a crushing shortage of tens of thousands of health care professionals nationwide, this bill only grants 300 visas and serves about a dozen hospitals. Many of these hospitals are located in the bill sponsor's home state of Texas.

Meanwhile, the Welcome Back Initiative seeks to recruit underemployed foreign-trained U.S. residents back into medicine. The initiative funds free resource centers that provide information on getting appropriate credentials to practice in the U.S., educational programs, and job opportunities. The initiative currently serves only nine areas of the country, however, virtually ignoring the Midwest and the South.

These recruitment tools, if limited (and, I suspect, politically fraught), are at least a step in the right direction toward solving a serious provider shortage in health care.

Annual Check-Ups Covered, Among Other Things

This week, a few key pieces of health care reform legislation went into effect, including coverage for preventative care visits. This very concrete change will have a big effect on families, who often coordinate several yearly check-ups for family members. A check-up required for a child to attend school should not cost a family with insurance coverage $200 out of pocket.

Lifetime caps on what health insurance will pay have also been removed, providing more financial security for people with insurance who become seriously ill. Children with pre-existing conditions must be covered by group health care plans as well.

WebMD has a good video interview with HHS Secretary Kathleen Sebelius explaining the changes that went into effect on September 23, and promoting the healthcare.gov consumer health care plan website.

These reforms have had some interesting consequences, though. A recent Fierce HealthPayer article pointed out that insurers such as Anthem Blue Cross, Humana, Aetna, Cigna, and UnitedHealthCare, for example, are trying to drop individual insurance plans for children in some parts of the country to avoid the expense of covering children with pre-existing conditions.

With more people getting and using health insurance under the new reforms, I was not surprised to read that the University of California at San Francisco approved funding for a new hospital complex this month. I wonder how many other hospital-building plans are going forward now that there will be more patients with insurance coverage to pay their bills. Will this new influx of patients (and payments) improve hospital care nationwide?

I've also heard rumblings about shortages of primary care doctors and nurses who will be needed to serve these new patients, a problem HHS is trying to remedy with financial incentives for health care providers who can fill this gap. The ongoing nursing shortage in particular seems to be a deeply entrenched problem nationwide.

I wonder what other changes - anticipated or not - health care reform might bring?