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Rural Physician Grant Program

February 9, 2022
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WRITTEN BY Dr. Joshua Mueller and Dr. Ramon Martinez III

Missouri counties with the greatest healthcare needs (i.e., areas with the highest prevalence of health conditions and a relatively low abundance of providers) are predominantly rural and located south of the Missouri River. Recruitment and retention of physicians in these areas can be difficult; in response to ongoing and projected physician shortages, several programs, including student training grants and loan repayment, have been enacted to promote healthcare workforce development. HB 1630 would establish a rural primary care physician grant program, which would pay $10,000/year to primary care physicians who agree to practice in underserved rural areas for five years. 


  • Over the past decade, the number of physicians in rural areas of Missouri has declined by 7%, and is estimated to further decrease 20% by 2030.
  • Physicians in areas with smaller populations, fewer physicians, and fewer hospitals are more likely to migrate away from rural areas than their non-rural counterparts.
  • Several types of physician incentive programs help recruit and retain rural physicians (medical student scholarships, service-option loans, student loan repayment, direct payments to physicians, and medical resident support). Over 90% of physicians receiving direct payments, loan repayment, and resident support complete the term of service required by the incentive program.
  • Other program designs may be slightly less effective, as 66% of scholarship recipients and 45% of service-option loan recipients complete their terms, respectively.


  • There is a lack of comparative studies analyzing how the size of incentive payments offered to physicians affects recruitment and retention.
  • The number of physicians and healthcare facilities in a county may not be perfect indicators of health needs, as telehealth options may provide additional healthcare resources.
  • Financial incentive programs are successful at short-term recruitment of rural physicians, but long-term retention and effectiveness studies are still needed.


This Note has been updated. You can access the previous version (published April 2021) here.

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