AHA's Rural Podcast Series

Rural America is in crisis. A spike in suicides and deaths by substance abuse has strained communities already struggling with a lack of clinical and inpatient resources. But there is hope.

In part two of this special podcast series, John Supplitt, senior director of Rural Health Services, AHA and Jordan Steiger, senior program manager, AHA clinical affairs and workforce, are joined by Stephanie Greer, president of Cannon Memorial Hospital, an Appalachian regional behavioral health hospital and critical access hospital in Newland, North Carolina.

Listen to how Cannon Memorial succeeded in obtaining an unprecedented Medicare waiver that allowed it to expand the inpatient capacity for psychiatric services in the community.

Welcome to the American Hospital Association’s new podcast series #JustLead, which highlights how hospitals and health systems that have been recognized with AHA Awards for innovation, collaboration, and health equity, are transforming health care for their communities.

The AHA’s annual Dick Davidson NOVA Awards specifically recognize those programs that are helping to address many of our nation’s most pressing health challenges while creating healthier communities and increasing well-being for their neighbors.

One of the five programs recognized with a 2022 AHA Dick Davidson NOVA Award is The Doorway at Cheshire Medical Center, in Keene New Hampshire. The Doorway specializes in substance use disorder, finding new ways to reach out to and treat that vulnerable population. Nelson Hayden leads the program; and Laurie Butz-MeyerRose is a clinician at Doorway.

Rural America is in crisis. A spike in suicides and deaths by substance abuse has strained communities already struggling with a lack of clinical and inpatient resources. But there is hope. Led by their local health systems, two rural communities in Colorado and North Carolina have rallied to meet the challenge — and they’re changing the fortunes of those that live and work there. In this two-part series, we learn how these communities are developing new and innovative solutions to build capacity for behavioral health services.

In today’s part one podcast, John Supplitt, senior director of Rural Health Services, AHA, and Jordan Steiger, senior program manager, AHA clinical affairs and workforce, start the discussion with some alarming statistics about the prevalence of mental health issues — including thoughts of suicide in many rural communities. Then Will Cook, President and CEO of Vail Health in Colorado, joins the podcast, to discuss solving the “paradise paradox” and stemming the surge of suicides in Eagle River Valley, Colorado.

Some 63 million rural residents across the U.S. depend on their area hospital as their primary – and often only – source of accessible medical care. Yet a variety of factors have caused the closure of 136 rural hospitals from 2010 to 2021, with a record 19 closures in 2020 alone. Most reasons are economic. They include low reimbursement rates, staffing shortages, low patient volume and regulatory barriers, as well as the continued financial challenges associated with the COVID-19 pandemic. More recently, expenses for labor, drugs, supplies and equipment have skyrocketed.

In this podcast Jeff Subler, president and CEO of Wayne HealthCare in Greenville, Ohio, discusses the unique challenges facing rural communities and rural hospitals, the impact closures have on the communities they serve, and the role Congress must play in extending programs such as the Low-volume Adjustment that support rural hospitals. 

Recently, the hospital leadership team of Ouachita County Medical Center in Camden, Ark., made the “heart-wrenching decision” to close a rural health clinic that the hospital had operated for 25 years. Leaders and staff also took wage cuts and reduced work hours. Take that one sad event . . . multiply it by more than 135 times over the past dozen years . . . and you’ve got some idea of the alarming economic challenges facing our nation’s rural and low-volume hospitals. Hospitals and health systems across the United States are experiencing unprecedented financial pressures right now. Labor shortages, increased expenses, and lower Medicare and Medicaid reimbursement rates impact most care providers, and none more so than rural hospitals.

On this Leadership Dialogue Series podcast, AHA Board Chair Wright L. Lassiter III is joined by Peggy Abbott, CEO of Ouachita County Medical Center, to discuss how the current economic stressors are affecting the small, rural hospital she leads. Like every hospital leader, Abbott’s foremost concern is keeping the doors open and continuing to meet patients’ and community health needs. Lassiter and Abbott talk about what that’s going to take . . . what changes are needed to keep the health care system in America as we know it functioning. As Abbott says, Hospitals are too important to every community to let any hospital fail — we need every hospital.”

Some 57 million rural Americans depend on their hospital as an important source of care as well as a critical component of their area's economic and social fabric. In many areas, there is growing concern…that fabric is starting to fray.

The stresses of the past 2.5 years have affected every hospital and health system in America, none more so than rural hospitals. On this Leadership Dialogue Series podcast, AHA Board Chair Wright L. Lassiter III is joined by Dr. Julie Yaroch (Yarrow), president of ProMedica Charles and Virginia Hickman Hospital in Adrian, Michigan. Lassiter and Yaroch talk about the issues that rural hospitals continue to face, including workforce shortages, increased costs of care, and an aging population. At the same time, patients living in rural communities must navigate challenges related to accessing care, such as lack of transportation and unreliable or unavailable internet access. Yaroch says collaboration is key right now. She describes how the hospital she leads views health care as a team approach and talks about its vital role as an anchor institution in the community.

Winona Health and the Winona Wellbeing Collaborative have addressed the fragmentation and silos between local agencies and providers. Hear from Rachelle Schultz, Ed.D., CEO, Winona Health and community leaders how the Pathways Community HUB model was used as a framework in designing the Winona Community HUB to serve the unique needs of the region. A community connector from Live Well Winona tracks the progress of clients through the HUB model, which is sustained by commercial payments for completed pathways.

Since the onset of the COVID-19 pandemic, digital solutions, including mobile health apps, patient portals and telehealth serve as a critical access point for health care providers to reach patients. However, many individuals have not been able to benefit from these digital solutions. In this podcast, Julia Resnick, director of AHA’s Strategic Initiatives is joined by Priya Bathija, vice president of AHA’s Strategic Initiatives and Sarah Swank, Counsel at Nixon Peabody. Priya and Sarah will discuss their upcoming article on digital health equity in a special edition of the American Health Law Association Journal of Health and Life Sciences Law. Here, they discuss barriers to access digital solutions and the role of health care leaders, including attorneys, in improving digital health equity.

Rural hospitals are community strongholds, serving as the key point of care for nearly 20 percent of Americans. Beyond providing healing and hope, rural hospitals nationwide are pillars of their local economies, creating essential jobs that support families and community vitality. Access to behavioral health services has been a chronic need across rural America for decades. Driven largely by shortages of clinical professionals, the demand for care has only grown during the COVID-19 pandemic. While tele-behavioral health has shown promise, much more must be done to eliminate the disparity and access to care and treatment to those who live in rural communities. On this podcast we hear from 3 leaders from across rural America who found a way, tele-health, outpatient, and inpatient, to deliver essential behavioral health services to the residents of their communities.

A confluence of economic factors have skyrocketed the cost of caring for patients and communities. In this podcast that highlights a new report from the AHA detailing these factors, Philip Pandolph, president and CEO, Meadville (PA) Medical Center and Chair of the AHA Rural Health Services Committee, explains how rising costs for supplies and equipment, drugs, and labor, along with inflation and razor thin margins has left his hospital vulnerable.