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Leveraging Grant Opportunities to Increase Access to Care in Rural Areas

Leveraging Grant Opportunities to Increase Access to Care in Rural Areas


The client is a small, rural critical access hospital under the governance of a larger health system within the state. Seeking to address the health care needs of the surrounding local community, the hospital was interested in exploring ways to bring more physicians into the area.


The hospital is located in a primary care, dental health, and mental health Professional Shortage Area (HPSA) and provides care to a Medically Underserved Area/Population (MUA/P). They are dedicated to serving the needs of their community but realize the limitations that the lack of physicians imposes. The client was interested in addressing the physician shortage through the development of GME programs designed to bring providers into the rural area; however, they could not support GME on their own. The client faced barriers including limited resources, limited funding, and a lack of infrastructure. The health system under which it is governed had another hospital with an existing Family Medicine residency program, but this program was based in the urban setting – missing the rural training focus that the client desired and the community needed.


The client engaged Germane Solutions to investigate the opportunities for bringing physicians into the local area. Driven by the need for and impact of primary care services, the client wanted to focus on increasing the primary care physician availability.

Germane identified a two-part solution for the client: develop a Family Medicine Rural Training Track (FM RTT) Program with the support of the Health Resources and Services Administration (HRSA) Rural Residency Planning and Development (RRPD) Grant Program. The FM RTT would serve as the vehicle for bringing primary care physicians into the community, year after year. The RRPD Grant would provide the financial support to mitigate program planning and development costs. Germane brought this recommendation to the client, outlining the process for each step and how it would achieve their overall goal of addressing the physician shortage in their community. Germane also investigated the client’s eligibility for the grant. Focused analyses were completed to understand how the client could partner with the existing Family Medicine residency program in the urban setting to create an FM RTT. Germane also conducted research about the community itself, their unique health needs, and the barriers to care they face. It was confirmed that the client was eligible for the RRPD grant, and an application was begun.

With Germane’s expertise of both HRSA and Accreditation Council for Graduate Medical Education (ACGME) rules and requirements, the client was assisted in creating a comprehensive, compliant HRSA RRPD Grant application. This application included a fully planned FM RTT program based at the client’s rural hospital in partnership with the urban FM program. Support strategies were outlined – for land, labor, and capital needs – and resident recruitment and retention plans were detailed. The goal to retain at least 50% of graduates in the surrounding counties to practice autonomously drove each component of the application.


Upon receival of the Notice of Award (NoA), the client was awarded the full requested amount of $750,000 from HRSA, the maximum RRPD award available. This funding is to be used over a 3-year period for the planning and development of the FM RTT program. With this support, the client was well-positioned to create an FM RTT program that will provide comprehensive clinical training and education to develop residents into independent rural family medicine physicians. The experiences residents receive through the FM RTT will prepare them to serve the unique needs of the patient population. The format of the FM RTT also provides the opportunity for the urban partner hospital to increase their Medicare FTE cap and receive CMS reimbursement for resident FTE spent at the urban site. Through Germane’s guidance and support, this client has been able to achieve its goal of creating a pipeline of primary care physicians into their service area to address the physician shortage and, ultimately, the community health needs – today and tomorrow.


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