Maternal Health Workforce Sustainability

As the need for rural maternal healthcare providers has become more and more critical, some medical schools have increased opportunities to place students and residents in rural hospitals and clinics, such as the University of Wisconsin-Madison Rural Ob-Gyn residency. Some state governments also created incentive programs that pay residents to complete their residency in underserved areas if they commit to practicing in rural communities for a designated period of time following their residencies. There are also incentive programs that promote careers in healthcare for American Indian students; these programs place healthcare professionals within medically underserved Indian health programs and provide financial support for tuition and fees in exchange for their service.

Healthcare systems may provide sign-on bonuses and loan forgiveness programs to potential maternal healthcare employees as well as referral bonuses to current employees who recruit new healthcare providers. Recruitment efforts should also communicate the benefits of rural living and target prospective healthcare providers who express interest in being part of a small community. Emphasis can be placed on the short commute and recruiting other family members by highlighting schools, local attractions, and other opportunities.

Increasing the number of nurse midwives providing maternal healthcare in rural communities may improve rural maternal health. There may also be opportunities to increase the use of nurse practitioners to provide maternal healthcare services. Some states currently do not allow nurse practitioners (NPs) to provide a full-spectrum of primary care unless supervised by a physician. For example, a physician may need to sign off on a prescription written by the NP. Some states also provide lower Medicaid reimbursement for NPs practicing a full spectrum of care than for physicians. Addressing scope of practice limitations and lower reimbursement rates for NPs at the state level are ideas that could incentivize NPs to choose rural communities for their primary care practice.

It is important for community leaders to engage with their healthcare systems and legislators to discuss challenges and possible solutions that will address each community's needs.

Resources to Learn More

Bureau of Health Workforce
Website
Provides information and resources to increase access, supply, training, and distribution of a quality healthcare workforce in areas of need. Identifies designated shortage areas in the U.S. eligible for various programs to recruit and retain primary care providers including training grants, loans, loan reimbursements, and scholarships.
Organization(s): Health Resources & Services Administration

Recruiting Rural Healthcare Providers Today: A Systematic Review of Training Program Success and Determinants of Geographic Choices
Document
A review of published and gray literature identifying the significant elements and incentives in recognizing which healthcare providers should be targeted for rural placement thereby maximizing recruitment efforts.
Author(s): MacQueen, I., Maggard-Gibbons, M., Capra, G., et al.
Citation: Journal of General Internal Medicine, 33(2), 191-199
Date: 2/2018

The RTT Collaborative In Rural Health Professions Education & Training
Website
A consortium of rurally focused health professional educators and trainers working with undergraduate and graduate medical education programs to support health professions education in rural areas. Focus is on mutual encouragement, practice improvement, peer learning, and technical assistance in a variety of specialties.
Organization: The RTT Collaborative