HJBR Mar/Apr 2024

that after we see them in the inpatient set- ting, we’re able to follow up with them in the clinic setting. We don’t just talk about their acute problems, but we talk about their chronic medical problems, their mental and physical health.” Oluseye — who joined the program after travelling fromLagos, Nigeria, through Rus- sia and the United Kingdom — mentioned recent examples of ways he’s improved Lou- isiana patients’lives. He recalled an encoun- ter with a woman who lived in unsafe hous- ing and suffered from chronic obstructive pulmonary disease, anxiety, and depres- sion after recently losing her job. “We real- ized that it wasn’t just about treating her comorbidities,” he said. “So, we connected her with social services. She was able to get a place. Eventually she was able to get a job. She even got off her antidepressants. It was her environment that was causing her depression.” Developing Louisiana’s Primary Care Strategy Gov. Landry’s Transition Team recom- mended that policy leaders “identify more opportunities to partner with primary care physicians and align incentives to prioritize preventive care and patient engagement.” Some experts have pointed to potential improvements that begin in medical school, Mike Thompson serves as a healthcare policy analyst and media liaison for the Louisiana Hospital Association. Prior to moving to the LHA, he worked in Washington, D.C., as a legislative assistant to members of the U.S. House Committee on Ways and Means and the U.S. Senate Committee on Finance. He holds a Master of Science degree in communication from the University of Louisiana at Lafayette and a graduate certificate from George Washington University. Mike Thompson Healthcare Policy Analyst & Media Liaison Louisiana Hospital Association including exposure to primary care physi- cians as mentors. LSUHealth Sciences Cen- ter Family Medicine Chair Emilio A. Russo, MD, FAAP, said, “If in 12 months at LSU, only three and a half weeks [of training for third-year medical students] are dedicated to family medicine, how do we expect peo- ple to imagine themselves as primary care docs in Avoyelles Parish?” “How many months do they spend in an outpatient facility with primary care docs?” said Levine. “The answer’s almost none. So, you can’t get what you don’t teach.” Several experts mentioned low reim- bursements as a deterrent for medical stu- dents who might otherwise choose to work in primary care. Others spoke about the cur- rent potential to increase rural family phy- sicians’ reimbursements by training them to perform colonoscopies and other proce- dures. They also mentioned the importance of moving to value-based care for primary care and recommended evaluating Louisi- ana’s health insurance companies’ perfor- mance in this area. Rep. Echols criticized low primary care physician reimbursements from Medicaid managed care companies, noting that “we need a Medicare-based rate for our primary care providers. Right now, especially in our rural areas with Medicaid, our payment methodologies are 30% to 50% less than an average Medicare rate.” Louisiana leaders could also explore what area health education centers (AHECs) have done in other states to support new rural primary care physicians. For example, North Carolina’s Mountain AHEC obtained grant funding to help new rural doctors integrate behavioral health in their care teams and receive peer support. State leaders could also consider how other states have supported GME. The U.S. Government Accountability Office found that “70% of hospitals trained more resi- dents than Medicare funded.”According to AAMC, Louisiana has more than 400 resi- dent slots that are not funded by Medicare. Several state legislatures have established grant programs to assist new or expanding GME programs, including Florida, Georgia, Indiana, Iowa, NewMexico, Nevada, North Dakota, Oklahoma, Texas, and Wisconsin. A number of states also provide tax incen- tives for preceptors who train medical resi- dents, including Alabama, Colorado, Geor- gia, Hawaii, Maryland, Missouri, Ohio, and South Carolina. Expanding physician access could sig- nificantly improve Louisiana’s ability to become a healthier state by 2030, and state leaders have taken important first steps in this direction. n HEALTHCARE JOURNAL OF BATON ROUGE I  MAR / APR 2024 15