Washington, D.C.—On Monday, February 10, 2025, Congresswoman Diane Harshbarger (TN-01), Congresswoman Kim Schrier (WA-08), and Congressman Don Bacon (NE-02) reintroduced the Rural Physician Workforce Production Act (RPWPA), a vital step toward strengthening the health care workforce.

"By addressing long-standing barriers to Graduate Medical Education (GME) for rural hospital training programs and expanding training pathways in rural communities, this bipartisan bill will help bridge workforce gaps and improve access to high-quality primary care. The Council of Academic Family Medicine (CAFM), which includes the Society of Teachers of Family Medicine, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, and NAPCRG, looks forward to ongoing collaboration with Congress to advance this essential legislation and support the health needs of rural America," says Winston Liaw, MD, MPH, Chair, Academic Family Medicine Advocacy Committee.

As it stands, Medicare accounts for two-thirds of public funding for residency training and program requirements influencing physician workforce distribution. Many rural areas lack access to primary care physicians and other specialties compared to urban and suburban areas.

While 20% of the U.S. population lives in rural communities, only an estimated 10% of physicians practice in those communities. Physician distribution is influenced by training, and most practice within one hundred miles of their residency program.

Unfortunately, rural hospitals typically cannot afford to create residency programs because they operate on narrow margins and require a predictable source of funding. Moreover, caps on the number of Medicare-funded GME residents created by the Balanced Budget Act of 1997 have limited the growth of GME in rural areas and not kept pace with the 27% rise in residents since enactment.

Here’s some key information on the RPWPA:

1. Targeted GME Funding for Rural Training
   1. The bill removes barriers in the Medicare GME funding system that make it difficult for rural hospitals and training programs to receive appropriate support.
   2. The proposed legislation ensures rural residency programs receive adequate funding to train and retain physicians in rural communities.
2. Expanding Rural Residency Training Opportunities
   1. The proposed legislation allows rural hospitals to receive full-time equivalent (FTE) resident slots, helping them build sustainable training programs.
   2. The bill promotes collaboration between urban and rural hospitals to strengthen rural clinical training sites.
3. Fixing Medicare Reimbursement Challenges
   1. The bill corrects outdated Medicare funding policies that have historically disadvantaged rural training sites.
   2. The RPWPA ensures residency slots at rural hospitals are appropriately funded, preventing unnecessary financial barriers.
4. Strengthening the Rural Healthcare Workforce Pipeline
   1. By expanding access to rural training experiences, the bill encourages more medical students and residents to pursue careers in rural medicine.
   2. Studies show that physicians who train in rural settings are more likely to stay and practice in those communities.

The Rural Physician Workforce Production Act is a crucial step toward addressing physician shortages and ensuring that rural communities have access to the healthcare providers they need. CAFM urges Congress to swiftly advance this bipartisan legislation to build a stronger, more sustainable health care workforce for generations to come.

Read the full bill text here.