Primary Care

Primary care is an approach to health care that emphasizes keeping people healthy, rather than merely treating illness. The approach applies to medical, oral and behavioral health.   Access to primary health care is essential for overall good health.

In parts of Missouri, a shortage of primary health care providers makes it difficult for low-income, uninsured and geographically isolated Missourians to receive health care.  By working with health care providers and communities, access to care can be improved for the underserved.  Health care professionals willing to work in underserved areas may be eligible to receive incentives through the following state and federal programs:

Health Professional Incentive Programs (HPIPs) were established to increase access to primary care in Health Professional Shortage Areas (HPSAs) in Missouri. A HPSA designation recognizes a particular geographical area, population, or facility is experiencing a shortage of primary care services. Section 332 of the Public Health Service Act provides the Secretary of Health and Human Services the authority to designate HPSAs.

The three (3) programs offered through HPIP are:

  1. Primary Care Resource Initiative for Missouri (PRIMO). PRIMO is a multi-faceted approach to improve the availability and the delivery of health care services for all Missourians. PRIMO provides incentives to increase the number of primary medical, dental and behavioral health care professionals through financial aid to students.

    In addition to the student loan and loan repayment programs, PRIMO coordinates efforts through:

    Recruitment/Placement Services
    work with organizations to assist in recruitment and placement of health professionals in underserved Missouri HPSAs.

    Health Care Delivery Systems seek to improve the delivery of health care by partnering with statewide organizations, communities and academic institutions to support the building and equipping of clinics, treatment centers and other economically sustainable health care delivery sites.

  2. Nurse Student Loan Program provides financial aid to students pursuing careers as licensed practical nurses or professional nurses in Missouri.

  3. Health Professional Loan Repayment provides funding for the repayment of qualified educational loans. This Loan Repayment Program provides two loan repayment options:

      • The State Loan Repayment Program (SLRP) is funded through a combination of federal and cost sharing state funds. It provides funding to the following primary care disciplines in exchange for practicing in a Health Professional Shortage Area (HPSA) in Missouri for a contracted time period.
          • Primary Care physicians
              • family practice
              • general internal medicine
              • geriatrics
              • pediatrics
              • obstetrics/gynecology
              • psychiatry
          • Primary care/general dentists
          • Psychologists (PhD, PsyD, EdD)
          • Licensed Clinical Social Workers

      • The Nurse Loan Repayment Program (NLRP) is offered to assist in alleviating the critical shortages of nurses. Funding for this program is provided through nurse license renewal fees. The following category of nurses is eligible for financial assistance in return for working in a Missouri hospital, federally qualified health center or HPSA for a contracted period of time.
          • Doctoral nurses
          • Advanced Practice nurses
          • Registered nurses

The National Health Service Corps (NHSC) is a federal program aided by State Primary Care Offices in the recruitment and retention of primary medical, dental and behavioral health care clinicians in HPSAs. The NHSC awards scholarships and loan repayment to primary care providers who commit to serving at NHSC approved sites for contracted periods of time. NHSC-approved sites are outpatient, ambulatory care settings that provide treatment regardless of patients’ abilities to pay for services. These sites accept Medicare and Medicaid reimbursement, and offer services on a sliding fee schedule.

The Missouri Primary Care Office joins the NHSC in observing the annual Corps Community Day, during Primary Care Week to conduct a variety of events and activities in an effort to recruit additional primary health professionals and to strengthen the understanding of the importance of access to primary care. Corps Community Day is October 10, 2013. We need your help to make this day a success.

Federally-Qualified Health Centers (FQHCs) are community-owned health care centers providing affordable primary medical care which also may include on-site dental and behavioral health care, as well as substance abuse and pharmaceutical services. FQHCs serve as medical homes to thousands of Missourians, offering care to all ages regardless of the ability to pay for services. Payment is determined by a sliding fee schedule utilizing family income-based poverty guidelines. Look at this map for locations of FQHCs, Rural Health Clinics and hospitals.

Another avenue that addresses the health professional shortage is the J-1 Visa/State 30 Waiver Program.  This federal program allows a foreign medical graduate to attend an advanced training program in the United States and waives the requirement for graduates to return to their native country.  The physician’s waiver is granted in exchange for an obligation to work for three years in a Health Professional Shortage Area in Missouri.

National Interest Waiver, or NIW, is a federal program that allows foreign-trained doctors, in exchange for a waiver, to work in medically underserved areas of the United States.  This program is also governed by Missouri State Statute.