Last week, the Workers’ Compensation Research Institute (WCRI) held its annual conference in Boston. I did not attend, but thanks to WCRI’s Andrew Kenneally for inviting me.
However, Joe Paduda did attend, as did David De Paolo. The subject of last week’s conference was the Affordable Care Act (ACA) and its impact on Workers’ Compensation. One of the presentation sessions Joe and David attended was given by the WCRI’s Executive Director, Dr. Richard Victor.
In this presentation, Dr. Victor mentioned some key issues that the expansion of Medicaid would have under the ACA that could impact Workers’ Compensation. As reported by Joe, an expansion of Medicaid could lead to a shortage of providers to treat workers, which may lead to longer disability and higher costs. Joe went on to add that Dr. Victor gave the opinion that in states where Medicaid expands shortages will be greater than in non-expansion states.
But what really caught my attention were which states, according to Joe, and predicted by the WCRI, will have primary care shortages. These states are:
California
Florida
Louisiana
Texas
New Mexico
Nevada
Mississippi
It occurred to me that most of these states, with the exception of Louisiana and Mississippi, have the highest percentage of Hispanics (Mexican and others) in the US. So in order to prove that, I went online to see if I could find data to back up my hypothesis. What I found by going to Wikipedia was the following:
Note: Four states have expanded Medicaid: AZ, CA, NV & NM.
These are the states with the highest % of Hispanics. TX is the lone
exception.
In those states that have already expanded Medicaid, the percentage of Hispanics range from 29.6% to 46.3%. They will also be, according to the WCRI, some of the states that will experience a shortage of providers to treat injured workers.
Those states that have not expanded Medicaid will also see a shortage of providers, so whether or not Medicaid is ever expanded in those states, an alternative must be found to alleviate the shortage in all of these states. That will require a radical re-thinking of who is currently allowed to provide medical care to injured workers.
And given the increasing number of Hispanics in the total population of the US, cross-border medical care (tourism, if you like) and actual medical tourism to other countries in the Western Hemisphere, will increasingly seem like a logical and necessary solution to the shortage of workers’ compensation medical providers.
This is already happening in the counties bordering Mexico in California, as I have previously mentioned in Cross-border Workers’ Compensation a Reality in California, but for states like Texas (where I understand many legislators were interested in the idea, but physicians along the border were against it, and it went nowhere), Arizona, New Mexico, Nevada and Florida, the increase in Hispanic population may eventually force their legislators to consider cross-border or medical tourism as an option to the physician shortages in their states.
I also mentioned the issue of physician shortages due to the ACA in my post, Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare?
The pressure to do so may not exist for some time in Louisiana and Mississippi, given their low percentage of Hispanics. Like the expansion of Medicaid in those states that have not expanded, only time will tell if they will consider medical care abroad.
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