Impact of the rural health clinics services bill: a projection

A survey of directors of midlevel practitioner training programs was conducted to analyze the projected impact of the Rural Health Clinics Services Bill (PL95-210). Sixty-eight percent of the directors responded. The majority of the respondents agreed that the bill would have a positive impact on accessibility and continuity of care and would increase the number of practitioners in rural areas. The directors of nurse practitioner programs disagreed with the directors of physician assistant programs over the issue of physician supervision and midlevel practitioner responsibility for care. Almost half of the respondents believed that the legislated method of reimbursement was not optimal, and 58% felt that financial abuses of the bill may occur. The legal implications of the bill and its impact on cost of care are discussed.