HHS Secretary Becerra: Nevada ‘Still The Wild Wild West’ Of Health Care Policy

Nevada’s well-documented health care shortages are a source of frustration for many, but U.S. Department of Health and Human Services Secretary Xavier Becerra believes it also presents opportunities.

“Nevada’s growing, Nevada is new, and Nevada is seeing the challenges of being new – of not being the go-to place for somebody wanting to be a doctor when it comes to medical school or residency,” Becerra said

Becerra made his comments Thursday during a roundtable at Roseman University with U.S. Rep. Susie Lee and leaders from local universities and medical groups. He discussed the HHS Health Workforce Initiative, which launched in July and is designed to support programs that develop more health care professionals while also identifying potential policy barriers.

Becerra said he would like Nevada leadership to submit proposals to HHS to address the shortage either through the new initiative or through more residency spots: “Nevada would be a great test case for us. How can we take a state that continues to grow but doesn’t have the assets that attract that future doctor, that future nurse?”

Every county in Nevada has a shortage of primary care physicians and mental health providers. The state also has a shortage of almost every specialist provider, ranging from OBGYNs to dentists.

Nevada ranks 45th in the country when it comes to the number of active physicians per capita, 48th for primary care physicians, and 49th for general surgeons, according to American Association of Medical Colleges data from 2021.

The state would need an additional 2,561 physicians in the workforce to meet national standards, according to a peer-reviewed article on the state’s health care worker shortage.

“We, in Nevada, always have to bemoan where we stand because we face challenges. I think part of it is because we’re such a new state,” Lee said. “We became one of the last metropolitan areas to have a public medical school… More than half of Nevada’s 17 counties do not have a hospital or a birth center that offers obstetrics, Nevada has the highest percentage of one-star acute care hospitals, and obviously, a huge factor contributing to poor access is having a shortage of workers.”

Discussions on Nevada’s reimbursement rates for care by insurance companies like ensuring parity in pay for telehealth and mental health care and making the licensure process easier for those who were medical professionals in other countries also surfaced during the panel.

“We’re trying to do what we can to accelerate the movement towards providing adequate mental health services but we’re very far behind. The other thing we’re doing right now is we’re working hard to get insurance companies to reimburse providers in behavioral services appropriately,” Becerra said. “Too often what we’re hearing from providers is that they don’t get reimbursed at the same scale that those who do physical or regular health do.”

These issues of parity and licensure highlighted the need for policy reforms that were present in the 2023 legislative session.

Three years ago, Nevada started tracking the reasons specialists were denied by insurance companies into their plans with the top reason being that the specialty was not needed or it was outside of the service area, according to the review of insurance denials by the Nevada Department of Insurance (DOI) for 20202021 and 2022.

That explanation was cited more than three times the rate of every other option given.

In 2020, across all specialties, 324 providers were denied entry to insurance company networks in the state. In 2021, a total of 624 providers were denied. In 2022, 918 providers were denied. Those denied included specialists in OBGYN, mental health professions, and dental care.

But policies like having insurance companies accept any willing provider in their network were watered down and a bill that would prohibit corporate hospitals and hospital systems from directly hiring physicians was vetoed in the 2023 legislative session.

Ultimately, for the federal government to help with Nevada’s health care shortage, Nevada must help itself first by policies set by the state like licensure and creating meaningful efforts to keep medical professionals in the state, Becerra said.

“In a way, Nevada is still the wild wild west, it’s still an open frontier when it comes to health care that being said we can do things at our level, the federal level, that we can’t do at places more established,” he said.


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