Loan Repayments Increase for Primary Care Providers in Underserved Areas

The federal Health Resources and Services Administration (HRSA) has increased by 50 percent the down payment loan amount available to primary care providers who commit to practice in areas with a significant shortage of primary care providers.

With the rising cost of medical school and increased challenges in recruiting primary care providers in high-need areas, HRSA said the action would help rural and historically underserved communities attract providers to provide critical primary care services. These providers: physicians and doctors, including obstetricians, gynecologists, and pediatricians; nurse practitioner; certified nurse-midwives; and physician assistants—could receive forgiveness of up to $75,000 in exchange for a two-year service commitment.

HRSA also offers up to an additional $5,000 in loan repayment to all National Health Service Corps Loan Repayment Program participants who can demonstrate fluency in Spanish and who commit to practice in a high-need area serving patients with disabilities. limited English proficiency. Providers will demonstrate language proficiency through an oral exam administered through an accredited language testing organization.

People with limited English proficiency disproportionately experience poor health outcomes and often poor experiences with providers, including problems understanding doctors’ questions and diagnoses and reading and using prescriptions, referrals, and follow-up instructions.

“At the Health Resources and Services Administration, we are committed to taking action to help ensure that everyone has access to primary health care,” HRSA Administrator Carole Johnson said in a statement. “We know the importance of having a culturally competent and consistent source of primary care to improve health and well-being, manage chronic diseases and prescriptions, and coordinate across care teams. However, too often in rural communities and historically underserved communities, primary care remains difficult to access. That is why we are increasing our incentives to encourage primary care providers to practice in high-need communities by repaying a greater proportion of their educational loans.”

Through HRSA’s National Health Service Corps Loan Repayment Program, primary care medical providers could previously receive a maximum of $50,000 in loan down payment in exchange for a two-year full-time service commitment to practice in an area with a shortage of health professionals. This amount is almost the same as the program offered 30 years ago, yet the average medical student debt has more than quadrupled over the same period.

Now, eligible primary care providers can receive up to $75,000 in loan down payment in exchange for a two-year, full-time service commitment to practice in those same areas. Participants have the opportunity to receive additional funding to expand their service commitment.

The Biden-Harris Administration noted other actions it is taking to support the primary care workforce, including investments in:

• Train primary care providers through HRSA’s community Teaching Health Center Graduate Medical Education Program that is training more than 1,000 residents in more than 80 community residency programs;
• Support the creation of new primary care residency programs in rural communities, which when fully accredited and operational will have up to 540 positions for physicians in specialties including family medicine, internal medicine, psychiatry and general surgery;
• Conduct more than 25,000 trainings for practicing primary care providers, including pediatricians, obstetricians and gynecologists, nurse-midwives and other maternal health care providers to identify and treat mental health conditions among children and adolescents, pregnant and new moms;
• Train primary care residents in the prevention, identification, diagnosis, treatment, and referral for mental health and substance use disorder services to integrate behavioral health into primary care;
• Increase access to care for patients with special needs by training primary care medical students, physician assistant students, and medical residents in the care of people with intellectual and physical disabilities; and,
• Train new primary care providers in culturally and linguistically appropriate care for people with limited English proficiency through language immersion programs and other methods.

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