Rural Residency Planning and Development Program - Purpose. Intermountain Health will establish one ACGME-accredited Rural Track Program in southern Utah. St. George Regional Hospital will serve as the urban site and Cedar City Hospital will host the Rural Track Program (RTP). The project goals are to establish the accredited residency and rural track and build a sustainable training model that remains viable after the grant period. The RTP will train family physicians prepared for rural family medicine practice. Need. Iron County has a growing population of 62,252 residents, an 11.2% uninsured rate, and a 13.3% poverty rate. Cedar City Hospital's 2025 CHNA identified behavioral health, access to care, and chronic disease as top priorities. Iron County and the surrounding communities are designated health shortage areas and Utah ranks low nationally for primary care provider per capita. By 2028, Iron County is projected to be short 13 family medicine physicians and St. George short 25 primary care providers. Utah has no rural track programs, and southern Utah has no GME programs; this project would create the first. Approach. One unified ACGME-accredited family medicine program under a single Program Director will lead the RTP. Total complement will be about 24 residents, six of them RTP residents (two per class). RTP residents will spend ~67% of training in rural settings. PGY-1s will be based at SGRH with continuity clinics at Family Healthcare (an FQHC) and River Road Clinic. PGY-2s and PGY-3s shift to Cedar City Hospital and Valley View Family Medicine. The curriculum includes chronic disease management, maternal and child health, integrated behavioral health, procedural skills, and team-based rural care. Innovations include telehealth, mobile integrated care, and a direct-to-residency pathway with the University of Utah Southern Utah Regional Medical Campus. Work Plan. Year 1: convene a steering committee, appoint the Program Director, begin faculty recruitment, and develop the RTP curriculum. Year 2: finalize curriculum, execute Program Letters of Agreement, complete the pro forma, and submit the ACGME application. Year 3: recruit residents through online and in-person recruitment efforts, participate in the March 2029 Match, and matriculate the first cohort in July 2029. Milestones align with HRSA RRPD Year 1, Year 2, and end-of-period requirements. Organizational Capacity. Intermountain Health is the ACGME-accredited Sponsoring Institution for 15 GME programs across Utah and Colorado, including four family medicine residencies. Intermountain’s GME infrastructure, an established DIO, enterprise GMEC, standard policies, and existing academic compensation frameworks reduce start-up costs and shorten the accreditation timeline. Sustainability. Long-term financing is anchored in Medicare DGME and IME funding under Option 3, because SGRH and Cedar City Hospital are GME-naive and will establish new resident caps. Preliminary reimbursement modeling confirms both sites qualify. Complementary revenue includes state appropriations, potential Medicaid GME, time-limited Utah Rural Health Transformation Program funding, clinical revenue, and institutional commitments from both hospitals. Performance Management. The GME Director will serve as Principal Investigator and will coordinate closely with the Program Director, Program Manager, hospital CMOs, site directors, and other stakeholders to track HRSA-required metrics. Graduate outcomes (practice location, specialty, rural retention) will be tracked in New Innovations for at least five years after the first graduating class and reported publicly. Communities Served. The population served includes rural residents of Iron, Washington, Beaver, Garfield, and Kane counties in southwestern Utah, plus adjacent communities in northwestern Arizona and southeastern Nevada. These communities face federally designated primary care, mental health, and dental HPSAs and currently have no local access to GME-trained physicians.
