HB 2748
In CommitteeHouse
Primary care preceptorships
Using preceptorships to train primary care physicians.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill directs the Health Care Authority to study how much it costs to run primary care preceptorships—clinical training where medical students learn directly from experienced providers—especially in rural and underserved parts of Washington. It also reaffirms the state’s goal of increasing primary care spending to 12% of total health care costs and requires regular reporting on progress.
- Directs the Health Care Authority board to study the cost of primary care preceptorships (hands-on clinical training where medical students learn under supervision of practicing providers) for hospitals and other clinical settings.
- Requires the board to report its findings to the governor and legislature by December 1, 2027, with a focus on expanding training capacity in rural and underserved areas.
- Maintains existing requirements for the board to track and report on primary care spending as a share of total health care expenditures, with a goal of reaching 12% of total health care spending.
- Mandates annual reporting starting August 1, 2023, including breakdowns by payer, provider type, and service (e.g., physical vs. behavioral health).
- Requires consultation with primary care providers and relevant research organizations (e.g., University of Washington, Milbank Memorial Fund) to inform policy recommendations.
Who is affected
- Medical students and residents in primary care training — Medical students and residents who train in primary care through hands-on clinical supervision may benefit from reduced training costs and increased access to training opportunities, especially in rural or underserved areas.
- Hospitals and clinical training sites — Hospitals and clinical sites that host preceptorship programs may receive support to offset the costs of training primary care trainees, potentially increasing their capacity to train more providers.
- Residents of rural and underserved communities — Residents of rural and underserved areas may gain improved access to primary care providers as the bill aims to expand training capacity in those regions.
- State agencies and legislators — State agencies and policymakers will use the board’s reports and recommendations to guide health care spending and workforce development strategies.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
By requiring a study of preceptorship costs—especially in rural and underserved areas—the bill lays groundwork for future state investment in training primary care providers in areas with severe shortages, directly improving access for vulnerable populations.
HealthcarePeopleRef: Sec. 2(5)The 12% primary care spending goal, if achieved, would shift reimbursement incentives toward value-based, team-based care—reducing fragmentation and improving outcomes for chronic disease management, especially for low-income and elderly patients reliant on primary care.
HealthcarePeopleRef: Sec. 2(1)-(2)Annual breakdowns of expenditures by provider type and service (e.g., behavioral vs. physical health) will improve transparency and accountability, enabling better targeting of resources to underserved populations and reducing disparities in care access.
HealthcarePeopleRef: Sec. 2(3)(b)Mandating consultation with UW, Milbank, and other regional research bodies ensures policy recommendations are grounded in local evidence—increasing the likelihood that workforce development strategies reflect Washington’s unique rural-urban divide.
EducationPeopleRef: Sec. 2(4)Explicitly linking preceptorship efficiency to reducing medical student debt makes primary care more financially viable for students—potentially reversing the trend of trainees choosing higher-paying specialties, especially if future funding supports loan forgiveness tied to rural service.
HealthcarePeopleRef: Sec. 1(3)
Potential Concerns (5)
The bill mandates a study of preceptorship costs but does not allocate funding or create new enforcement mechanisms—meaning outcomes depend on future legislative action, making measurable public safety improvements (e.g., reduced ER visits due to better primary care access) speculative and delayed.
Public SafetyRef: Sec. 2(5)While the bill requires reporting on barriers to data collection, it does not fund infrastructure upgrades needed to standardize or digitize health data across local clinics and rural health systems—potentially increasing administrative burden on small clinics without additional support.
Local GovernmentLean peopleRef: Sec. 2(3)(c)The bill requires consultation with research organizations but does not mandate curriculum changes or funding for medical schools—so while it supports data-informed training, it may not significantly shift medical education priorities without further legislation.
EducationRef: Sec. 2(4)The preceptorship cost study does not address compensation for preceptors (i.e., practicing providers who mentor students), which could limit participation unless future funding is added—potentially leaving rural providers overburdened if they volunteer time without reimbursement.
HealthcareLean peopleRef: Sec. 2(5)Annual reporting on expenditures by payer and provider type may increase administrative complexity for small clinics that lack health IT infrastructure, though large health systems are better equipped to comply.
Business & EmploymentRef: Sec. 2(3)(a)-(b)
Who Is Most Affected
Rural and low-income patients stand to gain significantly if increased primary care training leads to more providers in underserved areas—reducing travel time, wait times, and ER overuse. However, benefits depend on follow-up funding and provider retention policies.
Medical students and residents may benefit from reduced training costs and more clinical placements, especially in rural settings. However, without guaranteed post-graduation job placement or loan forgiveness, many may still leave primary care for higher-paying specialties.
Hospitals and clinics hosting preceptorships may receive future state support to offset training costs, but the bill currently imposes no new funding—so short-term impact is neutral; long-term benefit hinges on subsequent appropriations.
State agencies (e.g., HCA) gain clearer data mandates and reporting authority, improving oversight capacity. Legislators gain evidence-based tools to guide future health spending—but no new budget authority is granted, limiting immediate impact.
Large health systems and insurers may benefit from standardized reporting and potential shifts toward value-based care, but small independent clinics may struggle with reporting burdens without technical assistance funding.