How Likely are Nurse Practitioners to Receive NHSC Loan Repayment?

For some students, becoming a nurse practitioner requires taking on tens of thousands of dollars in student loans. While advancing your career is ultimately worth the investment, paying back such a large sum of money can seem impossible. Fortunately, there are several options for healthcare providers looking for assistance repaying student loans. The National Health Service Corps (NHSC) is one of the better known programs offering up to $50,000 in loan repayment to nurse practitioners for a two-year service commitment. 

Given the large loan repayment award offered by the NHSC, many nurse practitioners look into the application process. It is important to note that the NHSC’s mission is to improve access to healthcare for medically underserved communities. So, sites qualifying for loan repayment are typically in areas of lower socioeconomic status, rural locations, or both. For those NPs who do take on the cumbersome NHSC application, and are willing to relocate to such an area, how many are likely to receive NHSC loan repayment?

The NHSC doesn’t publish exact data regarding the number of nurse practitioner applicants to the program who are selected for loan repayment benefits. NPs interested in the program, however, can use the following information to help determine their likelihood of receiving student loan repayment through the program. Here’s what you need to know. 

Funding, not availability is a limiting factor

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The overall process for assigning loan repayment awards to healthcare providers through the NHSC is as follows: 

  1. Each site is assigned a Health Provider Shortage Area (HPSA) score between 26 and 14 in descending order. A higher HPSA score indicates an area of greater medical need. 
  2. The NHSC is given an annual budget from the federal government that goes towards awarding loan repayment to eligible healthcare providers practicing in NHSC sites. 
  3. Applicants are accepted as loan repayment recipients based on HPSA score, from highest to lowest, until funding is exhausted. 

Some years, the NHSC is allotted a larger budget than in others. If you are applying for loan repayment in a lean year, this makes your chances of receiving an award less likely. Since the implementation of the Affordable Care Act, funding to the NHSC has grown making loan repayment more likely. 

Site selection matters

Not all NHSC sites are created equally. Applicants working at sites with higher HPSA scores are more likely to qualify for the maximum amount of loan repayment. I have talked with many clinics assigned scores of 14 or 15. Typically, the nurse practitioners working in these clinics do not receive NHSC loan repayment. Most clinics I talk with who have scores around 19 do employ NPs who have qualified for NHSC loan repayment. 

Nurse practitioners must also look at facilities with multiple locations closely in making employment decisions with the NHSC. If the NP is to work at multiple NHSC approved practice sites, each with different HPSA scores, the lowest score will be used to determine the order in which the application is reviewed and the likelihood of receiving repayment. For example, a nurse practitioner working for a community health center with three clinic locations having HPSA scores of 22, 20, and 14, and practicing at all three sites, would be placed on the same priority level as other NPs applying at sites with a score of 14. Nurse practitioners must be aware that even sites within the same health system may be assigned different scores. 

Personal circumstances play a part

Similarly to applying for college scholarships, the National Health Service Corps takes each nurse practitioner’s personal situation into account when deciding how to allot loan repayment funds. Preference is given to NPs with the following characteristics:

  1. Likely to remain in HPSA plus disadvantaged background – Nurse practitioners likely to continue practicing in a Health Professional Shortage Area and that come from a disadvantaged background are given priority in the loan repayment process. A disadvantaged background can be indicated by environmental or economic factors, or, by receipt of a federal Exceptional Financial Need Scholarship in the past. 
  2. Likely to remain in HPSA – The NHSC gives priority to nurse practitioners who are likely to continue to working with underserved populations. In the application process, this is indicated by experienced working with underserved populations through prior employment and volunteer experiences. The applicant’s background will also be taken into account. 

Site popularity counts

While most NHSC sites are designated as such because they have difficulty recruiting and retaining healthcare professionals, some sites are more popular than others. The National Health Service Corps sets a limit on the number of healthcare providers that can serve at a single site and receive NHSC student loan repayment at a given time. 

The NHSC loan repayment program allows one NHSC Scholar per discipline to serve at a given site within a yearly placement cycle. For organizations with multiple sites, one NHSC Scholar per discipline may serve at each site. Requests for an additional NHSC loan repayment participant may be submitted, however, most clinics cannot hire multiple nurse practitioners awarded NHSC loan repayment, of the same specialty, in a given year. 

In 2014, nearly 9,200 primary care providers, 18% of whom were nurse practitioners, served at nearly 5,000 different NHSC sites. The National Health Service Corps is a valuable opportunity for nurse practitioners with substantial student loan debt. NPs must understand how the program works and select a site maximizing the likelihood of qualifying for NHSC loan repayment benefits. 

Have you applied for NHSC loan repayment? How was your experience?


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