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News Roundup: More Docs in the Pipeline

 |  By John Commins  
   October 30, 2013

In the news: Enrollment in medical schools has hit record levels. Not-for-profit small hospitals' median financial ratios were mixed in 2012, and research finds that older cancer survivors in rural areas are more likely to forgo medical care for financial reasons than their counterparts in urban areas.

A lot of interesting news items cross my desk, but don't make onto the Web site because I simply lack the time to get to them all. Today I'll play catch up by offering quick takes on a handful of recent such stories.

Med School Applicants, Enrollment Reach New Highs
For all the talk about physician job dissatisfaction, there appears to be no shortage of people who want to attend medical school. The American Association of Medical Colleges reports that a record number of students have applied to and enrolled in medical schools in 2013. This is especially good news for rural and exurban hospitals and health systems, which have been particularly hard hit by the physician shortage.

AAMC says the total number of applicants to medical school grew by 6.1% to 48,014, surpassing the previous record set in 1996 by 1,049 students. First-time applicants, another important indicator of interest in medicine, increased by 5.5% to 35,727. The number of students enrolled in their first year of medical school exceeded 20,000 for the first time (20,055), a 3% increase over 2012.

"At a time when the nation faces a shortage of more than 90,000 doctors by the end of the decade and millions are gaining access to health insurance, we are very glad that more students than ever want to become physicians," AAMC President/CEO Darrell G. Kirch, MD, said in prepared remarks. "However, unless Congress lifts the 16-year-old cap on federal support for residency training, we will still face a shortfall of physicians across dozens of specialties."

"Students are doing their part by applying to medical school in record numbers. Medical schools are doing their part by expanding enrollment. Now Congress needs to do its part and act without delay to expand residency training to ensure that everyone who needs a doctor has access to one."

AAMC credits the overall growth in medical student enrollment in part to the creation of new medical schools as well as existing schools' efforts to expand their class sizes after the AAMC, in 2006, called for a 30% increase in enrollment to avert future doctor shortages.

In 2013, 14 medical schools increased their class sizes by more than 10%. Four new medical schools welcomed their first classes this year, contributing to about half of the overall enrollment increase. Since 2002, medical schools have increased the number of first-year students by 21.6%.

Small Hospital's Financial Ratios Show Effects of Industry Reforms

This may sound obvious, but Standard & Poor's Ratings Services is reporting that not-for-profit small hospitals' median financial ratios were mixed in 2012, in alignment with the degree of success these hospitals have had in responding to sweeping reforms in the healthcare industry.

S&P credit analyst Avanti Paul said in the report that median revenues, cash flow, and other measures of financial health reflected two diverging trends.

"Some hospitals were able to improve their margins and maintain balance-sheet flexibility despite their limited revenue base while others have been unable to cope with volume declines, physician turnover, or the costs of implementing electronic health records," Paul said.

S&P reports that higher-rated hospitals' financial profiles are getting stronger, while lower-rated hospitals are weakening. "We expect this trend to continue in the next two years if, as we believe, incremental credit pressures, such as continued volume declines and reimbursement constraints will continue to build and as a result test hospitals' performance, and likely lead to more mergers," S&P said.

Older, Rural Cancer Survivors Face Financial Woes
A new report shows that older cancer survivors in rural areas were much more likely to forgo medical and dental care because of financial concerns compared with older cancer survivors living in urban areas.

The study published in Cancer Epidemiology, Biomarkers & Prevention, shows that cancer survivors in rural areas age 65 or older were 66% more likely to forgo medical care and 54% more likely to forgo dental care because of cost, compared with their urban counterparts.

Study author Nynikka Palmer with the Department of Social Sciences and Health Policy at Wake Forest School of Medicine in Winston-Salem, NC, says the research found a wide disparity among older survivors "for whom health insurance coverage through Medicare is almost universal, while no disparity was found for younger survivors after controlling for various factors. This suggests that health insurance coverage alone may not ensure equal access to health care."

Palmer says older cancer survivors in rural areas may have to travel farther to reach a medical provider, causing them to incur greater out-of-pocket costs associated with travel and lost wages. They may also face challenges with social support and transportation issues if younger family members leave rural areas for better economic opportunities in cities.

"While insurance coverage may not have fully explained rural-urban disparities in older survivors, we did observe strong associations between health insurance and forgoing care," Palmer said. "With the expected changes in health care policies in the forthcoming year, it will be important to assess the impact on rural and urban cancer survivors."

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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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