Health Professions Education:

Role of Title VII/VIII Programs in Improving Access to Care Is Unclear

HEHS-94-164: Published: Jul 8, 1994. Publicly Released: Jul 8, 1994.

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William J. Scanlon
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Pursuant to a legislative requirement, GAO reported on strategies and programs to increase the number of primary care providers and improve access to care in underserved areas, focusing on whether: (1) available data show that program changes have led to greater access to health care in rural and underserved areas; and (2) evaluations show that these changes were attributable to the programs.

GAO found that: (1) the supply of health professions has increased faster than the population, but data are not available to determine whether rural and underserved areas have greater access to health care; (2) the supply of primary care providers and general dentists has increased in some areas but not in the most underserved urban and rural areas; (3) minority representation in health professions has increased faster than the professions' total increase; (4) program evaluations have not shown that the programs have had a significant effect on the changes in supply, distribution, and minority representation; (5) the effect of the programs on health professions is difficult to measure because the programs have additional objectives, there are no common outcome goals or measurements, and evaluators are unable to separate the effects of other funding sources; and (6) Congress has recently targeted more program funding specifically for primary care and underserved areas, but this is not likely to have much impact.

Matter for Congressional Consideration

  1. Status: Closed - Not Implemented

    Comments: Recent actions and reports by authorizing and appropriation committees no longer reflect and interest in implementing this recommendation.

    Matter: To the extent that Congress chooses to use Title VII and VIII programs specifically to improve supply, distribution, and minority representation of health professionals, it needs to better ensure that the programs are structured and that funds are used for these purposes. Specifically, Congress should establish, or direct the Secretary of Health and Human Services to establish: (1) specific national goals for Title VII and VIII programs; (2) common outcome measures and reporting requirements for each goal; (3) restrictions limiting the use of funds to activities whose results can be measured and reported against these goals; and (4) criteria for allocating funding among professions based on relative need in meeting national goals.


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