Medical Licensing Compacts Backgrounder
O C T O B E R 2 0 1 3
THE COUNCIL OF STATE GOVERNMENTS
The cost o health care in the United States has grown anaverage o 2.4 percent aster than the gross domestic prod-uct since 1970 and now represents 18 percent o the totalGDP, according to the Kaiser Family Foundation. Onechallenge contributing signifcantly to these costs is accessto health care in hard-to-serve locations.Problems accessing care is especially common in ruralareas. According to the American Academy o Family Physi-cians, 21 percent o the U.S. population lives in rural areas,but only 11 percent o medical specialists practice in thoseareas. The group notes that because o this disparity, patientsin these areas are requently dramatically undeserved. Thesepatients oten do not have access to the latest research, scien-tiic breakthroughs and medicine because o where they live.Missed appointments and incomplete care can contribute toescalating health care costs.Experts expect this problem to worsen as the popula-tion grows and ages and the number o insured Americansseeking health services increases as a result o the PatientProtection and Aordable Care Act. Research publishedby the Annals o Family Medicine estimate the UnitedStates will need an additional 52,000 primary care physi-cians by 2025 to keep up with growing demands on thehealth care system.One possible solution is a series o medical licens-ing compacts intended to reduce existing barriers to theprocess o gaining licensure in multiple states. This hasthe potential to help acilitate telemedicine—the use o technology to aid in the delivery o medical services acrosslong distances—and widen access to a variety o medicalservices in underserved areas o the nation as the Aord-able Care Act is implemented. Licensing compacts alsoprovide a mechanism to ensure state regulatory agenciesmaintain their licensing and disciplinary authority, while si-multaneously providing a ramework to share inormationand processes essential to licensing and regulation across avariety o medical proessions.
Interstate Compacts as a Solution
Interstate compacts oer one approach to achieve thesegoals, and in turn, improve access to health care throughtelehealth. Compacts are unique tools reserved or statesthat encourage multistate cooperation and innovativepolicy solutions while asserting and preserving statesovereignty.Compacts, which are governed by the tenets o contractlaw, give states an enorceable, sustainable and durabletool capable o ensuring permanent change without ed-eral intervention. With more than 215 interstate compactsin existence today and each state belonging to an averageo 25 compacts, there is considerable legal and historicalprecedence or the development and use o the tool.Several existing compacts deal specifcally with licensingissues. Compacts such as the
provide precedence ormember states to honor licenses issued in another memberstate. For these reasons, a variety o medical proessionsare considering interstate compacts as a tool to breakdown existing barriers to multi-state practice.
Ongoing Medical Licensing Compact Work
EMS Licensure Compact
CSG, through its National Center or InterstateCompacts, has been working with the National Associa-tion o State EMS Ofcials to explore a multi-state EMSlicensure compact. It is becoming more common or EMSpersonnel to cross state lines to provide services in a statein which they are not technically licensed and do not enjoylegal recognition. Drating or this is well underway. Com-