Investigators at Mass General Brigham and the Richard A. and Susan F. Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center have found that international doctors sponsored by H1-B visas in 2024 comprised nearly 1% of the entire physician workforce in the United States, with substantial variation in different countries’ reliance on H-1B-sponsored physicians and other health care professionals.
The research, published in JAMA, comes out just weeks after a presidential proclamation that substantially increased employers’ fees for H1-B visa applications.
“Our findings suggest that the most socioeconomically vulnerable communities will be hit hardest in terms of health care worker supply and care access by the recent visa application policy change,” said lead author Michael Liu, MD, MPhil, a resident physician in the Mass General Brigham Department of Medicine.
“Foreign health care workers fill critical gaps in health systems such as primary care and rural health, and millions of Americans depend on them to receive timely and high-quality health care.”
The presidential proclamation increased fees for new H1-B visa applications, which allow foreign doctors, advanced practice providers such as nurse practitioners and physician assistants, dentists, and other health care workers to work at U.S. health care facilities—from an average of $3,500 to a fee of $100,000.
To better understand the potential impact of this policy on the U.S. health care system, the authors evaluated the annual percentage of U.S. health care professionals sponsored for H1-B visas and reliance on H-1B visas across occupations and county characteristics.
Liu and his colleagues analyzed data on all H-1B visa applications in fiscal year 2024 from the Department of Labor, aggregating the total number of health care professionals sponsored for visas at the county level.
They found that H-1B–sponsored health care professionals accounted for 0.97% of physicians (11,080 out of 1,138,056), 0.02% of advanced practice providers (122 out of 641,605), 0.40% of dentists (1,004 out of 251,551), and 0.07% of other health care workers (132 out of 181,495).
The percentage of H-1B–sponsored physicians was nearly two times higher in rural compared with urban counties, and nearly four-times greater in the highest versus lowest poverty counties.
“Our study provides evidence supporting proposed exemptions from H1-B visa fee increases for physicians, along with their extension to other health care workers,” said senior author Rishi Wadhera, MD, MPP, MPhil, the Associate Director of the Smith Center.
More information:
Liu M et al. Health Care Professionals Sponsored for H-1B Visas in the United States, JAMA (2025). DOI: 10.1001/jama.2025.20931
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