On the heels of new legislation found in section 127 of the Consolidated Appropriations Act of 2021 (CAA), the ACGME announced in May 2022 a new Rural Track Program (RTP) designation intended to give teaching hospitals an opportunity to expand cap space through rural training. In a 2021 survey, nearly 60% of designated institutional officials (DIOs) surveyed said there have been discussions at their institution about expanding GME in rural areas. This new designation will allow hospitals to increase access to physician services in rural and medically underserved areas and get funding for it thanks to the passage of the CAA.
Historically, only family medicine (FM) programs have expanded through an RTP designation. These programs needed to be separately accredited (Type 1), requiring additional cost and effort from program and hospital leadership (e.g., new program infrastructure, expanded timeline, more resources). With the announcement of this new designation (Type 2), additional specialties (e.g., OB/GYN, general surgery) can now more easily create a track within an existing program, thus reducing the burden on programs. Table 1 below summarizes the differences between the two designations.
The Type 2 designation may be particularly impactful for large, public academic health systems that can now support training tracks in various specialties to serve their public missions and state mandates, with some offsetting revenue. Additionally, rural hospitals that partner with academic health systems to meet the needs of their communities due to physician shortages may benefit greatly from the creation of RTPs to help address these challenges.
During a recent ACGME webinar, nearly 70% of attendees indicated that their institutions are actively considering creation of an RTP funded by CMS. Doing so through a Type 2 RTP can provide a more cost-efficient way for urban hospitals to expand existing programs and further develop relationships with rural providers.
To determine whether an RTP is right for your teaching hospital:
- Evaluate your existing GME portfolio, particularly within FM, OB/GYN, and general surgery programs.
- Discuss with program leadership whether there is an interest in expanding existing programs.
- Assess need for rural outreach in your region.
- Consider potential partnerships with rural providers.
Last year, ECG helped 10 teaching hospitals expand their cap and secure more than $3 million in additional federal GME funding through the Consolidated Appropriations Act (CAA). Learn More
Published March 9, 2023
