Provider Retention in High Need Areas. Implication of NHSC LRP on Provider Person-Years

12/22/2014

Finally, we examine person-years of service across simulation sets and scenarios (Table VI.5).  Over both time periods and locations, there are 40,000 person-years of service.  Table 5 shows that in all scenarios person-years of service increase in period 1 compared to the case of no program.  That is to say, the program will increase person-years of service in high-need areas.  However, the magnitude of the increase diminishes as the strength of selection into the NHSC program on the basis of preferences increases.  That is to say, the more the program selects on the basis of preferences, the more it attracts individuals who would have chosen to locate in a HPSA in the absence of the program.  Less selection on preferences allows the program to attract individuals who would not have chosen to serve in a HPSA in the absence of the program.  As we explained in more detail in Chapter IV, paradoxically, the program is most successful in increasing person-years of service when it attracts individuals who are least likely to stay after completing their obligations.14

Table VI. 5: Person-Years of Service in Each Location

Scenario

Location 1

Location 2

Period 1

Period 2

Total

Period 1

Period 2

Total

Simulation Set 1

No Program

3,534

3,549

7,083

16,466

16,451

32,917

Scenario 1

4,284

3,549

7,833

15,716

16,451

32,167

Scenario 2

4,163

3,549

7,712

15,837

16,451

32,288

Scenario 3

4,054

3,549

7,603

15,946

16,451

32,397

Scenario 4

3,917

3,549

7,466

16,083

16,451

32,534

Scenario 5

3,739

3,549

7,288

16,261

16,451

32,712

Simulation Set 2

No Program

3,703

3,653

7,356

16,297

16,347

32,644

Scenario 1

4,406

3,653

8,059

15,594

16,347

31,941

Scenario 2

4,290

3,653

7,943

15,710

16,347

32,057

Scenario 3

4,197

3,653

7,850

15,803

16,347

32,150

Scenario 4

4,068

3,653

7,721

15,932

16,347

32,279

Scenario 5

3,949

3,653

7,602

16,051

16,347

32,398

Notice that within a given simulation set, person-years of service in period 2 are always the same.  This is because, in period 2, individuals always face the same incentives (wage differential) and have the same preferences and random shocks; they therefore make the same period 2-choice in all scenarios.


14 To be clear, the person-year gain results from the fact that, when selection is based less on preferences and more on other factors, many high-preference applicants who are rejected still choose to locate in the HPSA.

 

 

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