Today is National Rural Health Day!
While we celebrate the programs and partners focused on healthier rural communities, the Germane Solutions team thought it would be a fun exercise to highlight the available grant support and clarify definitions related to rural health education and training. More information on National Rural Health Day can be found on the National Organization of State Offices of Rural Health website. #powerofrural
Grant support funding for Rural Health and Primary Care GME Training Programs
(1) The Health Resources and Services Administration (HRSA) offers a Rural Residency Planning and Development (RRPD) Program that funds the development of new, sustainable rural residency programs or rural track programs (RTPs) that are accredited by the Accreditation Council for Graduate Medical Education (ACMGE), to address the physician workforce shortages and challenges faced by rural communities. This includes ACGME RTP designation Types 1 and 2.
The most recent RRPD Notice of Funding Opportunity was HRSA-23-037. The application deadline for this round of funding is January 27, 2023.
(2) HRSA also offers a Teaching Health Center Planning and Development (THCPD) Program that supports the development of newly accredited community-based primary care medical or dental residency programs and residency programs in family medicine, internal medicine, pediatrics, internal medicine-pediatrics, psychiatry, obstetrics and gynecology, general dentistry, pediatric dentistry, or geriatrics to address shortages in the primary care physician and dental workforce shortages and challenges faced by in rural and underserved communities.
The most recent THCPD Notice of Funding Opportunity was HRSA-23-015. The application deadline for this round of funding is December 12, 2022.
(3) Additionally, HRSA offers a Teaching Health Center Graduate Medical Education (THCGME) Program that funds primary care medical and dental residency programs occurring in outpatient settings in the community, such as Federally Qualified Health Centers (FQHCs), Rural Health Clinics, and tribal health centers.
The most recent THCGME Notice of Funding Opportunity was HRSA-23-013. The application deadline for this round of funding has concluded but is typically released annually.
Research shows that only two percent of residency training occurs in rural areas. Also, graduates of THCGME programs were significantly more likely than graduates of other programs to practice close to their training sites and in rural areas or underserved areas and provide more clinical service than their peers. Fortunately, grant opportunities exist that can assist with creating new graduate medical education training programs and increase the number of physicians available in rural communities.
Definitions clarifying terms related to Rural Health
ACGME Definitions of Terms Specific to Medically Underserved Areas/Populations (MUA/P):
ACGME Rural Track Program (RTP)
An ACGME-accredited program in which all or some residents/fellows gain both urban and rural experience with more than half of the education and training for the applicable resident(s)/fellow(s) taking place in a rural area (any area outside of an urban Core-Based Statistical Area (CBSA).
ACGME Rural Track Program (RTP) designation*
A classification provided by the ACGME that identifies RTPs either with the approval of a permanent complement increase request and the addition/identification of at least one new rural participating site or at the time of application for accreditation.
ACGME Rural Track-Related Program
A separately accredited program in the same specialty at the same Sponsoring Institution in which residents/fellows have some overlapping education and training experiences with the ACGME RTP residents/fellows and may share resources (for new program RTPs).
County outside of an urban CBSA
*The ACGME RTP aligns with the rules and regulations of the Centers for Medicare and Medicaid Services (CMS) that address “rural tracks” in 42 CFR §413.79(k). The ACGME RTP designation is independent of any rural track designation by CMS. It does not guarantee that a program will meet CMS eligibility requirements for GME or other financial support.
More information on the Rural Track Program designation can be found on the ACGME website.
CMS Definitions of Terms:
Rural Training Program formerly called Rural Training Track (RTT)
A program that provides an opportunity for urban hospitals, rural hospitals, and nonhospital clinical settings to form partnerships to train residents to practice in rural areas.
Section 127 made several changes affecting urban and rural hospitals that train residents 
Rural Training Program (updated definition, effective October 1, 2022) 42 CFR 413.75(b):
“Rural Track Program means, effective for cost reporting periods beginning on or after October 1, 2022, an ACGME-accredited program in which residents/fellows gain both urban and rural experience with more than half of the education and training for a resident/fellow taking place in a rural area as defined at 42 CFR 412.62(f)(iii).”
Hospitals in “rural areas”
County outside of an urban CBSA. The hospital impact file on CMS’s website lists all hospitals by Medicare provider number. If a two-digit code is indicated for a particular hospital's geographic labor market area, then CMS considers the hospital to be rural.
The Association of American Medical Colleges provides a comprehensive Guide to the Medicare Requirements for Rural Training Track Programs. It is several years old but still contains beneficial information.
 United States Government Accountability Office. Graduate Medical Education: Programs and Residents Increased during Transition to Single Accreditor; Distribution Largely Unchanged. GAO-21-329. April 2021.
 Caitlin Smith Davis, Tuhin Roy, Lars E. Peterson, Andrew W. Bazemore; Evaluating the Teaching Health Center Graduate Medical Education Model at 10 Years: Practice-Based Outcomes and Opportunities. J Grad Med Educ 1 October 2022; 14 (5): 599–605. doi: https://doi.org/10.4300/JGME-D-22-00187.1
 ACGME Rural Track Program (RTP) Designation Frequently Asked Questions. https://www.acgme.org/globalassets/pdfs/acgme-rural-track-program-designation---faq-guide_web.pdf
 Section 127 of the Consolidated Appropriations Act: Graduate Medical Education (GME) Payment for Rural Track Programs (RTPs). https://www.cms.gov/medicare/acute-inpatient-pps/fy-2022-ipps-final-rule-home-page