This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.
National Health Service Corps expands the primary care workforce
U.S. Department of Health & Human Services, February 6, 2013
The National Health Service Corps awarded more than $10 million in funding for loan repayment to 87 medical students in 29 states, the District of Columbia and Puerto Rico, who will serve as primary care doctors and help strengthen the health care workforce, Department of Health and Human Services Secretary Kathleen Sebelius announced today.
Made possible by the Affordable Care Act, the National Health Service Corps’ Students to Service Loan Repayment Program provides financial support to fourth year primary care medical students in exchange for their service in the communities that need them most.
As a result of historic investments in the Affordable Care Act and the Recovery Act, the numbers of National Health Service Corps clinicians are at all-time highs. The number of providers serving in the Corps has nearly tripled since 2008. Today nearly 10,000 National Health Service Corps providers are providing primary care to approximately 10.4 million people at nearly 14,000 health care sites in urban, rural, and frontier areas.
NHSC Clinician Retention
National Health Service Corps
In addition to the recruitment of providers, the NHSC also works to retain primary care providers in underserved areas after their service commitment is completed to further leverage the Federal investment and to build more integrated and sustainable systems of care.
Short- and Long-Term Retention Rates
A 2012 retention assessment survey found that 82 percent of NHSC clinicians who completed their service commitment in the Corps continued to practice in underserved communities in the short-term, defined as up to one year after their service completion. Fifty-five percent of National Health Service Corps clinicians continue to practice in underserved areas 10 years after completing their service commitment.
Short-term retention increased by 28 percent when compared to the 2000 survey’s rate of 64 percent. The 2012 long-term retention (10 years after service completion) of NHSC clinicians in underserved areas is 55 percent, a 6 percent increase when compared to the 2000 rate of 52 percent. Long-term retention rates are higher for those who serve in rural as opposed to urban communities.
Retention: Primary Medical Care Providers
Physicians who completed their NHSC commitment more than 10 years ago had the highest retention rates as compared with physician assistants (PAs), nurse practitioners (NPs), and certified nurse midwives (CNMs). Ten years after their service commitment was completed, the retention rate for physicians was 60 percent. For nurse practitioners and certified nurse midwives, it was 59 percent; and for physician assistants it was 42 percent.
About the NHSC
National Health Service Corps
NHSC-approved sites are health care facilities that provide outpatient, ambulatory, primary health services in Health Professional Shortage Areas (HPSAs), which are communities with limited access to care. Sites (with the exception of Federally Qualified Health Centers and Indian Health Service sites) must apply to become an NHSC site. Once approved, NHSC sites gain access to desperately-needed primary care providers. NHSC providers often continue to work at their sites after they complete their NHSC service commitments.
Strengthening and growing our primary care workforce is critical to keeping this nation healthy. As more Americans gain access to health care, it is critical there are qualified health care providers to serve them. The NHSC, through its providers and sites, plays an important role in helping to address the country’s primary care shortage.
As we assess the severe deficiencies in our primary care infrastructure, it is important to recognize the phenomenal contribution of our National Health Service Corps in helping to meet the primary care needs in rural and urban Health Professional Shortage Areas.
Today’s HHS release reporting that 87 more medical students have been granted funds for student loan repayment in exchange for service in the NHSC, is great news as far as it goes, but it seems that an average of fewer than two per state is hardly a modest advance.
At a time when the politicos in Washington are talking about spending cuts, it seems that we should be reassessing programs such as this one. We should be spending more money on this important reinforcement of primary care.
Even if we had an improved Medicare for all, this program would be invaluable in helping to correct some of the structural problems within the health care delivery system. In fact, it would be great if it evolved into a program that would provide better access to ever more of us. Backing into a national health service would not be all that bad of an idea.
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