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.