Most states have some sort of loan repayment LRP) in place, and some even go so far as to cancel student loans for doctors who agree to work in underserved areas. However, their efficacy is mostly unknown when looking at these initiatives through the lens of safety net policies. Key results of state-funded  LRPs, state- and National Health Service Corps-funded LRPs, and loan forgiveness programs were evaluated through interviews with managers of safety net practices. Location managers in the healthcare safety net in 14 different states from 2011-2018 began their service when primary care, mental health, and dental health clinicians began. About 455 administrators (754 out of 1380 clinicians, or 54.6%) responded to the survey. How difficult administrators found it to hire clinicians for their sites; how quickly and how much it cost to hire the participating (index) clinician for the service program; how the program was expected to affect clinicians’ ability to stay with the organization; how well clinicians performed on the job after joining the organization. Despite the service program making it easier (81.7%) and faster (65.4%) for administrators to hire physicians in the index clinician’s specialty, it only sometimes reduced costs (34.8%). Nevertheless, most program managers (78.8%) believe that clinicians’ participation will increase their likelihood of staying with the organization. Care quality was high (96.9%), and participants were seen as helpful (92.4%). The evaluations of the 3 types of programs by their administrators were very similar. In most cases, safety net clinic administrators believe that state loan forgiveness and payback initiatives are helpful in their efforts to attract and retain qualified medical professionals.

Source: jabfm.org/content/early/2022/09/15/jabfm.2022.AP.220092

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