Wyoming lawmakers probe causes and solutions for widening provider shortages

On May 15, 2026 the Joint Interim Labor, Health and Social Services Committee heard multi-hour testimony on statewide shortages of physicians, nurses, pharmacists and long-term care staff and considered policy approaches ranging from rate changes to residency expansion.

France Fooks, deputy director of the Wyoming Department of Health, told lawmakers that Medicaid operates “like a relatively significant insurance company in the state” for low-income and disabled patients and that reimbursement rates are “the single most important lever we have” for keeping providers in network. She highlighted examples the department has already addressed with targeted rate increases, including home health and dental, and said nursing homes and some waiver providers are highly dependent on Medicaid—“nursing homes…we pay for 65% of the bed days” and some developmental-disability service providers rely on Medicaid for “90% plus” of revenue—making them vulnerable to closures if rates are insufficient.

Hospital leaders described similar pressure. Lance Porter, CEO of Banner Wyoming Medical Center, told the committee Banner’s payer mix is about 45% Medicare and Medicaid combined, with Medicaid around 10% and Medicare about 35%. “That payer mix is very important to us,” Porter said, noting that critical-access hospitals have different reimbursement mechanics than larger, prospective-payment-system hospitals and that recruitment is hampered by livability, salary competition and call burden.

Witnesses representing clinicians and professional associations pressed for concrete policy tools. Tony Decklever of the Wyoming Nurses Association described acute shortages of nursing assistants and regulatory limits that make it difficult to expand the instructor pool (federal rules require RN instructors with long-term-care experience). Decklever also noted that advanced practice registered nurses (APRNs) in Wyoming have statutory limits that often prevent them from admitting hospital patients and that changing those admission rules would require legislation.

Sheila Bush of the Wyoming Medical Society urged better data and long-term investments: Wyoming has roughly 1,500 active practicing physicians—about 180 physicians per 100,000 residents compared with a national average near 248—and limited in-state residency capacity. Bush recommended expanding residency slots, strengthening loan-repayment programs and improving licensing-board data collection; she also said tort-law changes (she cited past medical-review-panel efforts and Utah-style ‘shield’ laws) deserve study because liability concerns disproportionately affect some specialties such as obstetrics.

Other ideas discussed included regionalization pilots and targeted telehealth programs. Witnesses described a proposed “synchronous telehealth” pilot in which out-of-state specialists would consult in real time alongside local clinicians so patients could remain in their home clinics. The committee also discussed recruitment coordination through the Wyoming Health Resources Network and School-to-Scrubs outreach to funnel students into health careers.

Committee members asked staff and witnesses for follow-up materials, including precise hospital payer-share calculations, cost and capacity data for nursing programs, and comparisons of loan-repayment models in other states. The committee recessed for lunch and said it would return to other health items after the break.

The hearing left the committee with a short list of near-term levers—targeted rate increases for bottlenecked services, expanded residency and loan-repayment dollars, and capacity-building for CNA and nursing education—and longer-term policy options that require further study, including malpractice reforms and regionalization pilots.