North Carolina has invested in Primary Care.

But we must do more.

What NC is Doing?

The North Carolina General Assembly approved important legislation in 2023 for primary care. This included making key investments in its loan repayment programs for rural health professionals, as well as appointing a task force to study primary care.

Primary Care Payment Reform Task Force

The 2023-24 North Carolina budget created the ground-breaking North Carolina Primary Care Payment Reform Task Force that is:

  • examining the current healthcare spend on primary care services in Medicaid, commercial and Medicare Advantage plans,

  • studying the primary care landscape in other states,

  • and has made recommendations back to the NC General Assembly. The work and recommendations of the task force supports increasing primary care investment in North Carolina over time.

The task force released a full report of its findings in April, 2024.

Rural Clinical Teaching Hubs

The 2023-24 state budget also funded the NC Area Health Education Centers Program (NC AHEC) to study the need for community preceptors for clinical rotations in outpatient primary care for medical students, PA students, and NP students. This portion of the budget also directed NC AHEC to select or develop five rural clinical teaching sites that will receive $150,000 per year (recurring) to offset teaching time in those clinics. These sites will begin to train students in the 2024 academic year. The five clinics/areas selected are:

  • Atrium Health Foundation (clinics in Stanly, Cleveland, and Randolph Counties) 

  • Campbell University Community Care Clinic (Harnett County)

  • Sandhills Pediatrics (Moore County)

  • Englehard Medical Center (Hyde County, Dare County)

  • Roanoke Chowan Community Health Center (Hertford County)

Student Loan Repayment Program and Scholarships

The 2023-24 state budget also provided additional funding for two years for loan repayment programs for health care professionals, above and beyond the funding already in place, plus forgivable loans/scholarships for medical students. The two-year budget includes:

  • $9 million extra per year for two years for the existing State Loan Repayment Program, for which family physicians qualify.

  • A new Primary Care Loan Repayment Program of $5 million a year for two years for practicing family physicians, general internists, general pediatricians, OB/GYNs, psychiatrists, and general surgeons practicing in a critical access hospital.

  • A Forgivable Loan Program (up-front scholarships) for existing medical students interested in practicing primary care or psychiatry in rural areas of the state, which as written would include 80 of the state’s 100 counties. Eligible students can receive up to $25,000 per year of medical school, which will be forgiven if they work in a rural area one year for every year they receive the scholarship.

These are great steps toward supporting primary care and ensuring its future family physicians. But more needs to be done.