Categorized | Featured, Health

Loan repayment program encourages health care providers in rural areas

(Photo courtesy of UHM-JABSOM)


Gov. Neil Abercrombie on Thursday joined leaders from the University of Hawaii-Manoa John A. Burns School of Medicine (UHM-JABSOM), School of Nursing, and Hawaii’s health industry to announce the launch of an educational loan-repayment program to encourage health care professionals to practice in the most underserved areas in the state.

Under the State Loan Repayment Program, healthcare professionals who commit to serving for at least two years in areas where healthcare worker shortages are the most acute will be eligible to receive up to $40,000 per year, tax-free, to pay their educational expenses (student loans).

Physicians, physician assistants and nurse practitioners in federally recognized health professional shortage areas will be eligible.

Three factors played an important role in making this long-sought Hawaii program a reality:

* Abercrombie and members of the Hawaii State Legislature extended the Physician Workforce Assessment (Act 186-12) funding efforts to understand and begin to curtail the shortage of health care workers statewide. The governor and Legislature also approved a measure (Act 187-12, “Hawaii Health Corps) authorizing the University of Hawaii-Manoa schools of medicine and nursing to establish a Hawaii educational loan repayment program. The Hawaii Medical Education Council (HMEC), most of whose members are appointed by the Governor and confirmed by the State Senate, directed JABSOM Professor Kelley Withy, MD/PhD, to seek funding.

* HMSA (The Hawaii Medical Service Association) and The Queen’s Health Systems together pledged $150,000 each year for two years, to match funds requested from the U.S. government through the Health Resources and Services Administration (U.S. Department of Health and Human Services).

* The U.S. Government approved funding to the University of Hawaii through the Patient Protection and Affordable Care Act to support 12 Hawaii loan repayment contracts within the next two years.

“As promised in my New Day plan, ‘first things first’ — ensuring that our people have access to quality healthcare,” Abercrombie said. “This new program will help address a critical shortage of health care providers in our state in front-line, primary care, where it is most needed. We are building on federal initiatives to transform health care and working with community and industry partners to create opportunity to expand health services.”

JABSOM Professor Dr. Kelley Withy, MD/PhD, who heads the Physician Workforce Assessment and action plan, is overseeing the loan repayment program as Director of the Hawaii Area Health Education Center at JABSOM.

“Thanks to the generosity of Queen’s and HMSA, and a federal grant that matches their generosity dollar for dollar, we will begin paying back up to $40,000 a year in educational debt for physicians, nurse practitioners, and physician assistants next month,” Withy said.

An additional nine loan repayment contracts will be drawn up in 2013, she said.

“Through partnership with the State and legislation such as that which has created a Hawaii Health Corps, we hope to increase the number of loan repayment contracts to 50 a year within the near future,” said Withy. Withy noted that loan recipients will be chosen by a committee made up of representatives of the Director of Health (Hawaii State Department of Health), JABSOM and the UH Manoa Nursing Dean.

“Getting doctors to practice in rural areas is a major challenge, said Hilton Raethel, HMSA senior vice president. “This program is a vital step toward improving access to health care in our state’s underserved areas. Not only will it provide care to those in need, it will help build the doctor- patient relationships that are the foundation to a sustainable health care system for Hawaii.”

“The disproportionate distribution of health care providers in Hawaii leaves the often underserved rural areas lacking in accessible, quality health care services,” said Dr. Gerard Akaka, Vice President of Medical Affairs and Chief Medical Officer at The Queen’s Medical Center. “This program is vital for the future of health care in Hawaii as it will help to attract health care providers to serve the primary care needs in these areas.”

The Hawaii Health Workforce Assessment, renewed this year by the State Legislature (Act 186) through 2013, has found that Hawaii has a shortage of 600 physicians–half of them primary care physicians.

In addition, the state is short at least 150 primary care nurse practitioners and physician assistants.

“Primary care is the area of most need and fortunately, most of JABSOM’s students (64 percent of MD Class of 2012) choose to practice in primary care fields. Yet, for many students, primary care can seem the least attractive option — at least financially,” said Dr. Withy. “Physicians serving in primary care usually earn less than MDs in specialties (examples: cardiology, anesthesiology, dermatology, etc.). Students burdened by heavy educational debt may be less likely to choose primary care for that reason, adding to the physician shortage,” Withy said.

Each year, according to the medical school, JABSOM students are carrying several million dollars in educational debt. (For example, 48 members of JABSOM’s first-year MD class owe a total of $2,229,822.)

The average educational debt for an individual JABSOM medical student is $104,586.

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