By MAXWELL EVANS
Capital News Service
LANSING – A state loan reimbursement program is working to attract obstetricians to Northern Michigan, and while it’s been “beneficial,” there’s still a ways to go to address these rural areas’ needs, state and local health officials say.
State officials are gearing up for the 2019 application period, which runs Feb. 4-8, and have issued a call for physician applicants. The Department of Health and Human Services in 2013 made getting such specialists to the region a priority, said Lynn Sutfin, the agency’s public information officer.
The department defines obstetricians as OB/GYN physicians, certified nurse midwives and practitioners who provide obstetric services on a regular basis. The areas identified as having a “shortage” of them are in or north of Mason, Lake, Osceola, Clare, Gladwin, Arenac, Bay and Huron counties.
Baldwin Family Health Care in Lake County, for example, has no hired obstetricians, although one is contracted through Spectrum Health. The nearest dedicated obstetric facilities are more than 30 miles in either direction in Ludington and Big Rapids, according to Google Maps.
As an incentive to get such health providers there — as well as other specialists in other parts of Michigan — the state developed a program that gives participants up to $200,000 to repay student loan debt. In return, they must work full-time at a nonprofit practice at least 45 weeks a year for two years.
So far, 31 northern Michigan obstetricians have had loans repaid since 2013, with nearly $2 million paid out to them. In most agreements, 40 percent is funded by federal agencies, 40 percent by Health and Human Services and 20 percent by local nonprofit employers.
For-profit employers placing their participants in nonprofit practice sites like state prisons must contribute 50 percent.
One caveat: Employers can’t use program payments to offset participant salaries and benefits.
The employer contribution is worth the additional investment because it’s a challenge to draw providers to these “rural, underserved” areas, said Travis Kroll, the associate director of external and internal relations at Family Health Care in Baldwin.
“We have a very underserved population in our area that relies heavily on Medicaid and Medicare, as well as those with no insurance,” Kroll said. “This program helps us retain quality providers for that underserved population.”
The program met its objective of increasing the number of obstetric service providers in underserved areas each year from 2015 to 2017, according to its latest report to the Legislature. No specific increased amount was required for the goal to be met.
In addition to Baldwin, Alcona Citizens for Health, Thunder Bay Community Health Service, Kalkaska Memorial Health Center, Helen Newberry Joy Hospital & Healthcare Center in Newberry, MidMichigan Medical Center in Gladwin and Munson Healthcare Otsego Memorial in Gaylord are among the most frequent partners in the program, according to the department.
While health care services in areas like Baldwin have improved because of the reimbursement program, the needs of the region at large still haven’t been met, Sutfin of Health and Human Services said.
“It’s definitely made a dent — it’s helping,” Sutfin said. “Obviously with the fact that in northern Michigan, the obstetric providers became a priority type beginning in 2013, and here we are in the year 2019, there’s still work to be done.”
While the program has brought in “valuable providers,” no obstetric specialists came to the Baldwin care center because of the student loan incentive. Kroll said he’d like to see the program expand to incorporate fields like optometry and pharmacy, which he said residents in the region also need.
The state has no other initiatives to address the obstetrician shortage in the region. It’s possible the program will prioritize attracting other types of specialists up north, Sutfin said, but no specialties have been identified to date.
Other priority areas n the reimbursement program include inpatient pediatric psychiatrists across the state and primary care providers serving Genesee County. The employer contribution is waived for Genesee County sites.
In 2017, 11 of the 67 awards went to Genesee County providers, with another one given to a psychiatrist.