Perspective: Ensuring access in rural America

Nearly 20% of Americans live in rural areas. And, providing care in rural areas presents unique challenges. Geography is a challenge, with patient volumes and the shortages of medical professionals. Rural hospitals also face challenges related to payer mix, access to capital, providing behavioral health services, and adjusting to new delivery models. Moreover, rural hospitals are particularly sensitive to the impact of economic and demographic changes faced by their communities.
 
That’s why AHA launched our new Future of Rural Health Care Task Force: to help shape the future of rural health care delivery and ensure access to quality care in rural America for decades to come.
 
Many rural hospitals and health systems are already employing creative strategies to help secure their futures and their communities’ access to care. This includes addressing the social determinants of health to keep people healthy, experimenting with new payment models, and partnering with other entities to expand their capabilities and reach … just to name a few.
 
This task force will help rural providers take the next step by identifying future trends and emerging strategies, and developing new care delivery and stable financial models. And here’s a key point: We are determined not just to issue a report that will sit on a shelf … we are looking for ideas that can be turned into actions.
 
I’m pleased that Kris Doody — a former member of the AHA Board of Trustees and the CEO of Cary Medical Center in Maine — is chairing the group. She is an innovative leader in her own community and was instrumental in developing the first rural, community-based outpatient clinic for veterans. In addition, Cary Medical Center partnered with Tufts University Medical School to begin a nine-month rural rotation for third-year medical students to expose them to rural health care delivery and its challenges. She is a tremendous advocate for rural hospitals and is a champion for accessibility, affordability, quality and innovation. Moreover, the task force includes a diverse group of other leaders who are not only great thinkers … but doers — also using creative techniques to serve their communities.
 
Of course, addressing rural issues is nothing new to AHA. We’ve been continually working to ensure access to care in rural communities. Our latest AHA Rural Report recognizes the unique challenges facing different communities, whether it is rural, frontier, or resort; not to mention the ethnic and cultural diversity that each community represents.
 
While we are looking to shape the future, be certain: We are also focused on making immediate progress as well. We recognize that ensuring access to millions of Americans in rural areas is an urgent problem. And, thanks to our hard work, policymakers, the media and the public have taken notice.
 
For example: The House Ways and Means Committee just announced a new bipartisan task force to address the needs of rural and underserved communities. In addition, the Centers for Medicare & Medicaid Services recently announced it will be launching a new demonstration model for rural communities this fall. So the momentum is building. And Sen. Charles Grassley, R-Iowa, the chairman of the Finance Committee — and a consistent champion for rural hospitals — is working on a legislative package to address key issues.
 
That’s why, in the short-term, our agenda for strengthening rural access to care includes: ensuring fair and adequate reimbursement from Medicare and Medicaid that covers the cost of providing care; supporting new models of care that work for rural communities; removing red tape that does not improve patient care; expanding health IT, including improving broadband connectivity, promoting interoperability and expanding telehealth capabilities; bolstering the workforce; and reining in the high costs of prescription drugs so patients can access the treatment they need. These priorities need to be addressed to maintain and improve access to care in rural communities. 
 
For an in-depth discussion about this report and the challenges facing rural hospitals and communities, check out Wednesday’s installment of AHA’s podcast, Advancing Health, which features some of our top rural health policy experts.
 
Improving rural health is an AHA priority because we truly cannot advance health in America without keeping our rural communities strong.