ADDRESSING RURAL WORKFORCE SHORTAGES THROUGH RESIDENCY TRAINING
The client, a rural hospital, was deeply affected by and determined to address the shortage of physicians in their community. As part of a larger health system, the rural hospital was interested in attracting more physicians to provide care in their community but faced the challenges of high costs, limited funds, and lack of infrastructure.
95% of the 2,000 rural counties in the United States are entirely or partially in a primary care health professional shortage (HPSA). With interest in addressing the physician shortage in this rural area, the health system wanted to evaluate starting GME programs in partnership with one of their other hospitals (urban) with an existing Family Medicine program. The identified urban hospital endorsed this goal; however, it had already reached its maximum FTE cap for trainees, indicating that it would not receive any federal reimbursement for additional trainees. As such, the urban hospital could not support any additional programs at its urban site, nor could it support a rurally-focused training program due to its urban designation.
Determined to increase access to care for their community, the client requested Germane’s assistance in creating a pipeline for primary care physicians to serve their rural population. In the past few years, Germane has maintained a 100% success rate in GME grant development and writing and was well prepared to help the rural hospital meet its goals.
Germane recommended starting a newly established Family Medicine Rural Training Track (FM RTT) program. To assist with the planning and development phase of the FM RTT program, Germane identified a Rural Residency Planning and Development Program (RRPD) grant funding opportunity issued by the Health Resources and Services Administration (HRSA). The RRPD grant offered funds to support the planning and development costs for newly accredited and sustainable rural residency programs in primary care to expand the physician workforce needs in rural communities. This eliminated the client’s main challenge: program development costs.
Then, Germane investigated and confirmed the rural hospital’s eligibility to apply for the grant. Germane worked with rural and urban hospitals within the health system to design a high-quality FM RTT program that can partner with the urban hospital site’s existing Family Medicine Residency Program. The research was also conducted regarding the rural hospital’s county and patient populations they served, including an in-depth analysis of their community health needs assessment.
Within 35 days, Germane and the client developed a comprehensive application inclusive of a financial plan to sustain the programs for the future. The customized FM RTT program was structured to be in compliance with both HRSA and the Accreditation Council for Graduate Medical Education’s (ACGME) requirements. This application also included an extensive and sustainable framework and description of strategies for recruiting and retaining 51% of its residents within their rural community upon graduating from the program.
THE GERMANE EFFECT
The client received the full award amount of $750,000 from HRSA for a three-year performance period. This funding allows the health system to address the physician shortage and train residents in urban and rural settings, providing a unique and well-rounded clinical and educational experience. The residents’ training and presence will benefit both the urban and rural hospitals and their patient populations. Moreover, due to a newly established FM RTT program, the capped urban hospital will have the opportunity to increase their Medicare FTE cap and receive reimbursement for the FTE time the FM RTT residents spend in the urban setting.
With the assistance of Germane Solutions, the client’s Family Medicine Rural Training Track program also received a status of initial accreditation from the ACGME eight months after the grant award. The client now continues to work with Germane Solutions as they prepare to welcome their first class of rural residents in July of 2021.
1Department of Health and Human Services, Health Resources and Services Administration Data Warehouse, October 2019.