The AAMC submitted comments in response to the Bipartisan Policy Center’s (BPC) Rural Health Task Force request for comment on rural workforce, graduate medical education (GME), and solutions on barriers and opportunities for rural participation in new delivery models.
Regarding GME, the AAMC supports efforts to promote rural health training opportunities for both medical students and residents. Currently, urban hospitals can partner with rural hospitals and nonhospital settings to form Rural Training Tracks (RTTs). However, RTTs are currently limited to primary care residents. Congress should expand RTTs to include other specialties in order to promote training in rural areas. Furthermore, rural hospitals should be able to increase their full-time equivalent resident cap in order to accommodate more residents.
Some medical schools are also working to identify students who may be interested in practicing in rural areas by allowing students to experience unique opportunities in rural and underserved communities as part of their curriculum. Medical schools should be encouraged to partner with rural and underserved communities in order to expose students to these unique care settings.
Regarding rural participation in new payment and delivery models, rural providers face unique challenges in adopting new delivery models. Success or failure in many of these models depends upon a variety of factors, including timely access to care, the number of patients treated as part of the bundle, and a facility’s infrastructure. In addition, rural providers are often operating on leaner budgets and treating a population with higher prevalence of chronic conditions. Due to these considerations and other challenges faced by rural communities in providing health care to their residents, participation in new delivery models may be difficult for rural communities.