By NextBestFitHigher pay in shortage areas
Add a bonus to fees in shortage areas.
Simple add-on to the fee schedule.
Review ledgerHow this path connects
Addresses
Health professional shortage areasThis path
Higher pay in shortage areas
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Raise the shortage-area fee bonus
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Health professional shortage areas
Adding bonuses to the existing fee schedule in shortage areas is a simple change that can be implemented quickly.
What it creates or worsens
- Solves only part of the problem
Fee bonuses alone often do not move clinicians because schools and spouses' jobs also matter.
- Directs benefits or burdens imperfectly
Bonuses for shortage-area practice can go to providers already working there.
Who's affected
Who gains
- Rural residents
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- Low- and middle-income households
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- Residents of areas with too few health professionals
- Health professional shortage areas: Clinician shortages limit primary and mental health care access.
- Doctors, nurses, and other clinicians
- Health professional shortage areas: Adding bonuses to the existing fee schedule in shortage areas is a simple change that can be implemented quickly.
Who loses
- Taxpayers and public budgets
- Solves only part of the problem: Fee bonuses alone often do not move clinicians because schools and spouses' jobs also matter.
Where it has been tried
- U.S. Medicare HPSA bonus: 10% bonus in shortage areas.
- United States: In 2026, Medicare's shortage-area program provides eligible physicians a 10% quarterly bonus on payments for professional services.