Florida is leading the nation in health care reforms that can help unleash innovation and ensure patients have access to care as the state and country face of a growing physician shortage. Proposed legislation offers Florida lawmakers an opportunity to adopt a similar approach to dental care shortages in the state.
A recent Reason Foundation report rates all 50 states’ telehealth policies and finds that Florida is among the top-rated states for adopting best practices. The state has broadly permissive laws and rules that don’t give preference to one mode of telehealth or category of provider over others, creating opportunities for future innovation. Florida’s strong performance is a testament to state lawmakers’ efforts in recent years to reduce or eliminate antiquated regulations that constrain innovation.
A report from the Association of American Medical Colleges projects a nationwide shortage of between 17,800 and 48,000 primary care physicians by 2034. As reported, the shortage is likely to be especially acute in Florida because of the state’s rapidly growing and aging population.
Eight million Floridians, roughly 35% of the state’s population, live in areas with primary care health professional shortages as designated by the U.S. Department of Health and Human Services (HHS). According to HHS estimates, Florida could need an additional 22,000 physicians by 2030 to meet patients’ needs.
Florida’s embrace of health care innovation shines brightest when it comes to enabling telehealth services across state lines. In 2019, the state passed a first-in-the-nation law to allow health care practitioners licensed in other states to provide telehealth services in Florida without obtaining a Florida-specific license. Out-of-state providers can complete a simple registration process to verify they are licensed in good standing in another state and create mechanisms for addressing misconduct. According to a recent Cicero Institute report, more than 7,000 out-of-state practitioners, including nearly 3,000 physicians, registered to provide telehealth services in Florida during the 2021-2022 fiscal year.
The only area where Florida fails to achieve top marks in the report is in allowing nurse practitioners to practice to the full extent of their education and training. Nurse practitioners are highly trained professionals capable of providing much of the well-patient care traditionally provided by physicians. Florida’s nurse practitioner workforce is expected to nearly double by 2035 and could help make up for the anticipated physician shortage.
Following reforms in 2020, nurse practitioners in Florida are allowed to practice and prescribe medications independently, but only after accumulating 3,000 hours of clinical practice under the supervision of a physician and some additional graduate-level education. Florida’s approach can be seen as reasonable and not excessively burdensome, but other states allow nurse practitioners to practice independently without these requirements.
While Florida has made great strides toward embracing telehealth and leveraging the nurse practitioner workforce, the state is also expected to experience a shortage of dental care providers.
More than seven million Floridians live in HHS-designated dental health professional shortage areas. Florida needs an additional 1,536 dental care practitioners to offset the current shortage, according to HHS. Two bills working their way through the Florida legislature, Senate Bill 1254 and House Bill 1173, offer innovative solutions to current and future dental care shortages.
First, the bills would recognize dental therapists as a new category of licensed, mid-level dental care practitioners. Beginning with Alaska in 2005, 14 states have recognized dental therapists. Analysis by the James Madison Institute from these states finds that integrating dental therapists into the dental care workforce could contribute to reduced wait and travel times, cost savings, and improved patient satisfaction.
Much like the role of nurse practitioners, dental therapists could alleviate some of the strain on Florida’s dental care workforce by providing services that don’t require the unique expertise of a dentist. Unlike nurse practitioners, dental therapists cannot practice independently. The current proposals would instead require that dental therapists be supervised under a collaborative agreement with a Florida-licensed dentist.
Second, the proposed legislation would allow Medicaid reimbursement for dental services provided by mobile dental units through programs targeted at underserved populations.
Florida has made great strides in telehealth and health care, but there is certainly room for even more policy reform this legislative session.
A version of this commentary first appeared in the Sarasota Observer.