The Commonwealth Policy Coalition
Center for Healthcare Disparities
The CHD works to address complex healthcare policy issues such as rural healthcare workforce development, the preceptor shortage throughout Kentucky, disparities in healthcare access amongst communities, and enhancing educational opportunities for medical students to ensure the next generation of providers. Current and past policy projects hosted within the CHD include a geographically targeted preceptor tax incentive program using HPSAs, and a revised state loan repayment program to reward rural medical practitioners who have stayed in their communities.
Our Policy Work
Recruiting, Training, and Retaining Rural Health Professionals
Years before the COVID-19 pandemic brought on a health care shortage in America, its rural areas were already struggling to obtain and attract primary care medical practitioners. Even though the number of medical school graduates in the U.S. has steadily increased throughout the years, there is a general disinterest in rural or small-town practice, and experts project that this shortage will only be exacerbated in the future by the country’s recent population shift from rural to urban areas. In Kentucky currently, there are 191 Health Resources and Services Administration designated Primary Care Health Professional Shortage Areas (HPSAs), meaning that approximately 43% of the state does not have their primary care needs met. Physicians, advanced practice registered nurses (APRNs) and physician assistants (PAs) are considered to be the core disciplines in primary care. Because those that live in rural areas are already more likely to die from heart disease, cancer, chronic lower respiratory disease, and stroke than their urban counterparts, lack of access to this preventative primary care only perpetuates the health crisis in rural areas.
Each of these primary care disciplines (physicians, APRNs, and PAs) require significant clinical training during medical school that must be provided in community-based settings by community-based preceptors who are not employed by educational institutions. A preceptor is an experienced medical practitioner who voluntarily provides supervision during clinical practice. In Kentucky, these primary care preceptors are not currently compensated for taking on students to train; the ones that do so do it out of commitment to the betterment of the healthcare sector.
Thus, our policy creates a nonrefundable income tax credit to be claimed by any non-compensated, community-based, Kentucky-licensed medical preceptor located in one of Kentucky’s 191 HRSA-designated Primary Care Health Professional Shortage Areas (HPSAs) supervising 3rd and 4th year medical/osteopathic students, physician assistant students, and advanced practice registered nurse students.
The goals of this work are to enhance state investment in educational programs seeking to provide the next generations of primary care providers, decrease the number of Primary Care Health Professional Shortage Areas (HPSAs) in Kentucky, increase the number of primary care preceptors in the state, and ultimately combat health inequity in the state’s rural and underserved areas.
This proposal has resulted in the sponsorship of HB 718 in the 2022 Kentucky General Assembly legislative session.
Further reading:
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To read the full policy short brief, click here: A Geographically Targeted Approach for a Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (HPSAs) - The Commonwealth Policy Papers
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To read an example of draft legislation to apply this research, click here: Draft State Legislation: A Geographically Targeted Approach for a Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (HPSAs)