Evaluation of HRSA’s Nursing Education Loan Repayment Program and the Nursing Scholarship Program

Project Overview

Insight conducted a 5-year evaluation of two Health Resources and Services Administration’s (HRSA) programs—the Nursing Education Loan Repayment Program and the Nursing Scholarship Program. The evaluation assessed the impact of these programs on critical shortage facilities and the communities they serve. The programs were designed to encourage nurses to choose careers in underserved areas to reduce the nursing shortage and address the need for nurses in critical shortage facilities. They were the only federal programs designed to provide financial incentives directly to nurses in exchange for service in healthcare facilities experiencing a critical shortage of nurses.

The research design contained qualitative and quantitative components. Insight—

  • Designed logic models and performance measures (including the number of nurse graduates and those working in critical shortage areas)
  • Acquired, edited, and tabulated administrative data to monitor yearly trends (including the number of applicants, defaulters, awards, and funds obligated by demographics of program participants and shortage facility characteristics)
  • Conducted nationally representative surveys of nursing employers in underserved areas to measure the retention rate of nurse awardees in critical shortage facilities over time
  • Held discussion groups with nurse awardees and health facility administrators to explore the factors related to the successful placement and retention of nurses
  • Designed a cost-benefit analysis to determine the cost-effectiveness of providing scholarships and loan repayment to students; this analysis also quantified the number of additional years nurses must serve for the program to be considered cost beneficial

As mandated by the Nurse Reinvestment Act, Insight submitted an annual report to HRSA and Congress detailing the evaluation findings and recommendations. Specifically, these reports addressed (1) changes in the programs’ awardees over time, (2) the programs’ effectiveness in increasing the number of nurses serving in critical shortage facilities and improving the supply and distribution of nurses, and (3) the overall costs and benefits of the programs.


Final report, HRSA Responds to the Nursing Shortage: Results From the Nursing Education Loan Repayment Program and the Nursing Scholarship Program (June 2006)