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Frequently Asked Questions

Montana Family Medicine Residency
What is a THC?

What is a Teaching Health Center?

Teaching Health Centers (THCs) are community-based primary care training sites that provide medical education and residency training to healthcare professionals, with a focus on preparing them for practice in underserved areas. THCs are designed to address the shortage of primary care providers in medically underserved communities and rural areas.

Here are some key points about Teaching Health Centers:

1.     Purpose: The primary purpose of Teaching Health Centers is to train medical residents, and dentists to become competent primary care providers who can address the unique needs of underserved populations.

2.     Funding: Teaching Health Centers receive federal funding through the Health Resources and Services Administration (HRSA) to support the training and education of healthcare professionals. This funding helps cover resident stipends, faculty salaries, educational resources, and infrastructure development.

3.     Collaborative Partnerships: THCs often collaborate with community health centers, academic institutions, and other healthcare organizations to provide comprehensive primary care training experiences. These partnerships help integrate classroom learning with hands-on patient care in real-world settings.

4.     Focus on Underserved Populations: Teaching Health Centers prioritize training residents to deliver healthcare services to underserved and rural populations, including low-income individuals, racial and ethnic minorities, and those with limited access to care. The goal is to improve health outcomes and reduce health disparities in these communities.

5.     Integrated Care: THCs emphasize an interdisciplinary approach to healthcare, encouraging collaboration among various healthcare professionals, including physicians, nurses, behavioral health specialists, and social workers. This approach helps address the comprehensive needs of patients and promotes coordinated and patient-centered care.

6.     Community Engagement: Teaching Health Centers actively engage with their local communities to understand their specific healthcare needs and tailor their training programs accordingly. They often provide services such as health education, preventive care, and outreach programs to improve the health and well-being of the communities they serve.

7.     Career Opportunities: Upon completing their residency training at Teaching Health Centers, healthcare professionals are well-prepared to practice in underserved and rural areas. Many graduates continue working in these communities, helping to fill the gaps in primary care and improve access to quality healthcare services.

Teaching Health Centers play a vital role in training and cultivating a new generation of healthcare providers committed to serving underserved and rural populations, promoting health equity, and addressing healthcare disparities.

THC Cost

What does it cost to Train a THC Resident?

In 2019, HRSA commissioned a cost evaluation study to George Washington University to determine the actual cost associated with training a resident in a THC setting.  


They have determined the average cost to be a net of $209,623 per year per resident.  


This determination accounted for expenses and revenues highlighted below:


The expenses to train a resident in a Teaching Health Center (THC) can vary depending on several factors, including the location, specialty, program structure, and specific resources required for training. These costs can include:

  • Stipends and Salaries: This includes the compensation provided to residents in the form of stipends or salaries for their training period.

  • Benefits: Resident benefits such as health insurance, retirement plans, and other allowances.

  • Educational Resources: Costs associated with educational materials, textbooks, software, and other learning resources.

  • Licensing and Certification: Fees related to obtaining medical licenses, board examinations, and certifications.

  • Faculty and Staff: Costs associated with the recruitment, salary, and benefits of faculty members, program directors, coordinators, and other staff involved in the training program.

  • Administrative Costs: Expenses related to program administration, management, and compliance with regulatory requirements.

  • Facility and Equipment: Costs associated with maintaining training facilities, including rent, utilities, equipment, and supplies.

  • Accreditation and Compliance: Costs related to maintaining accreditation, fulfilling reporting requirements, and meeting compliance standards.


Teaching Health Center (THC) programs can generate revenue from various sources to support their operations and the training of residents. The specific revenue streams can also vary depending on factors such as the program's location, affiliations, and funding mechanisms. Here are some common sources of revenue for THC programs:

  • Medicaid Reimbursements: THCs often generate revenue through Medicaid reimbursements for the healthcare services they provide to Medicaid beneficiaries. As THCs typically operate in underserved areas, a significant portion of their patient population may be covered by Medicaid. Reimbursements from Medicaid can help offset some of the costs associated with patient care and support the financial sustainability of THC programs.

  • Medicare Reimbursements: THCs can also receive reimbursements from Medicare for the services provided to Medicare beneficiaries. This includes payments for physician services, diagnostic tests, procedures, and other eligible services. Medicare reimbursements can contribute to the revenue stream of THC programs.

  • Private Insurance Reimbursements: THCs that have agreements with private insurance providers can generate revenue through reimbursements for the healthcare services they deliver to patients covered by those insurance plans. Private insurance reimbursements can vary depending on the specific agreements and negotiated rates.

  • Philanthropic Support: Some THC programs may receive financial support from philanthropic organizations, foundations, or community donations. These sources of revenue can provide additional funding to support program activities, infrastructure improvements, research initiatives, and community outreach efforts.

  • State and Local Funding: In certain cases, THCs may receive financial support from state or local governments. This can include grants, subsidies, or other funding mechanisms that aim to promote healthcare access and address the needs of underserved populations within their jurisdictions.

  • It's important to note that the revenue streams for THC programs can vary based on program-specific factors and local circumstances. Each THC program may have its unique combination of revenue sources tailored to its operational model and the specific needs of its community.  Keep in mind programs are not allowed to "double dip" or secure other GME funding such as CMS, or VA for residents claimed as HRSA THCGME residents.


Federal Funding is the primary source of revenue for THC programs provided through a grant. The Health Resources and Services Administration (HRSA) is the key federal agency that provides financial support to THCs through the Teaching Health Center Graduate Medical Education (THCGME) program. This funding helps cover the costs associated with resident training, stipends, salaries, faculty development, and program administration.


The Per Resident Allocation (PRA) provided by HRSA as of July 1, 2022 is $160,000 PRA, whereas the actual cost is $209,623 PRA leaving many programs with inadequate funding to operate their programs.


Please find the provided links below to access the COGME presentations on the Cost Evaluation Data.


Teaching Health Center Graduate Medical Education (THCGME) Cost Evaluation Update, Jennifer Trott, M.P.H., Senior Researcher

Teaching Health Center Graduate Medical Education (THCGME) Cost evaluation Update, Marsha Regenstein, Ph.D., Professor, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University



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