Wednesday, February 6, 2013

Fwd: qotd: National Health Service Corps and primary care

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-------- Original Message --------
Subject: qotd: National Health Service Corps and primary care
Date: Wed, 6 Feb 2013 14:05:40 -0800
From: Don McCanne <>
To: Quote-of-the-Day <>

U.S. Department of Health & Human Services
February 6, 2013
National Health Service Corps expands the primary care workforce

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


National Health Service Corps
NHSC Clinician Retention

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.


National Health Service Corps
About the NHSC

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.

Comment: 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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