National Health Service Corps Caring for More Medically Underserved Americans

In the last three years, membership in the National Health Service Corps (NHSC) has tripled, according to Kathleen Sebelius, Secretary of Health and Human Services (HHS).  The NHSC is a national network of 10,000 primary-care providers and 17,000 sites in underserved communities with limited access to healthcare.

“When you don’t have access to primary care, small health problems grow into big ones,” Sebelius said.  “Way too many Americans have gone without check-ups, preventive screenings, vaccines, routine dental work and other care simply because there was no one to see,” Sebelius said.  The agency estimates that its providers care for approximately 10.5 million patients, compared with just 3,600 providers who cared for roughly 3.7 million patients three years ago.

The program, which is almost 40 years old — is administered by HHS’ Health Resources and Services Administration (HRSA) — and provides financial, educational and professional resources to medical, dental and behavioral healthcare providers.  According to HRSA the NHSC has awarded approximately $900 million in scholarships and loan repayment to healthcare professionals since 2008 to expand the agency’s primary-care workforce. That funding has come from the Patient Protection and Affordable Care Act (ACA), the American Recovery and Reinvestment Act (ARRA) and base appropriations.  “Eighty-two percent of NHSC clinicians continue to serve in high-need areas after they fulfill their service commitment,” HRSA Administrator Mary Wakefield said.  “These awards help ensure that underserved communities across the country have access to quality healthcare both today and in the future.”

“When you don’t have access to primary care, small health problems grow into big ones,” Sebelius said. “Most of these providers graduate with tens or even hundreds of thousands of dollars in loans, and it is very difficult to pay off while doing this important work.”

The Association of American Medical Colleges estimates that the nation will have a shortage of 91,500 physicians across all specialties just nine years from now. 

Despite the program’s recent significant growth, Wakefield said there are underserved areas of the country that qualify for National Health Service Corps members, but there is not enough money to fund providers there.  “It is a significant challenge,” Wakefield said.  “We have more sites that are designated or eligible than we have clinicians.  We also have, on the flip side, more students applying to National Health Service Corps than we have availability” to fund.

In Minnesota, for example, a state with vast wilderness areas, the federal government is providing $6.6 million in incentive dollars to doctors and nurses to increase the state’s number of primary-care providers.  According to Minnesota Public Radio, “Minnesota’s rural healthcare system is feeling new pressure.  National healthcare reform is forcing expensive record-keeping changes.  Greater reliance on Medicare and Medicaid reimbursement makes rural providers vulnerable.  Rural people tend to be older and poorer, are less likely to have insurance and suffer more chronic illness.  And the doctor shortage has gotten harder to deal with.  In response, care is changing.  Services like mental health counseling are delivered via teleconference.  Clinics and hospitals are consolidating.  ‘Mid-level’ practitioners like paramedics and dental therapists are starting to play new roles.”

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