The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies April. 12 held a fiscal year (FY) 2019 budget hearing titled “Investments in our Health Workforce and Rural Communities.” Much of the discussion focused on workforce shortages, rural hospital closures, and addressing opioid and substance abuse.
In his opening statement, Subcommittee Chair Tom Cole (R-Okla.) noted the importance of rural residency programs and the recruitment of individuals from rural communities to the health professions. This importance is underscored as the country faces shortages of almost 100,000 physicians by 2025 and the fact that one in four practicing physicians comes from outside the United States.
Ranking Member Rosa DeLauro (D-Conn.) praised additional funding provided in the FY 2018 omnibus [see Washington Highlights, March 23], but criticized the Administration’s proposed cuts to HRSA workforce programs.
In their testimony, Mr. Morris and Dr. Padilla echoed the impact of training and recruitment in rural and community-based settings to rural practice. Specifically, Mr. Morris noted that physicians are twice as likely to practice in rural settings when they are in rural training tracks. Chairman Cole asked what HRSA is doing to encourage medical schools to do more in rural settings. In response, Dr. Padilla highlighted Teaching Health Center GME, Primary Care Education and Training, and the National Health Service Corps programs at HRSA. Chairman Cole also highlighted workforce diversity as a rural issue, including underserved tribal areas.
In addition to rural hospital closings, Rep. Chuck Fleischmann (R-Tenn.) asked about rural access hospitals that are ineligible for the Medicare Value Based Purchasing program due to low patient volume. Mr. Morris pointed to other alternative payment models that include these facilities, such as Accountable Care Organizations (ACOs).