Roundup: What’s Being Done to Address Rural Healthcare Inequities?
Several states are experimenting with ways to help rural hospitals stay afloat. / The Georgia Legislature worries about the impact of Governor Kemp’s budget proposal on rural communities. / Rural Americans travel three times farther for breast cancer treatment. / An error that will not die.
We read a lot about the problems of delivering healthcare in rural America. Michael Ollove at Stateline, the news service of Pew Charitable Trusts, investigates some of the solutions.
Ollove’s report is the closest thing we’ve seen to a comprehensive report on state initiatives to address rural healthcare deficiencies like lack of access, poorer overall health, and insufficient numbers of healthcare providers. The article is well worth a read. Here are some highlights:
“Among the ideas,” Ollove reports, are “creating private-public partnerships to increase access to care, sending mobile medical units into remote areas, expanding telemedicine and encouraging young people in rural communities to go into health professions.”
Pennsylvania’s efforts get a special call out from Brock Slabach, senior vice president of the National Rural Health Association, who calls the program the “‘the boldest’ state rural health initiative in the country,” Ollove reports.
The program will help ensure reliable revenue for 13 participating hospitals.
The idea is that by giving hospitals certainty about their budgets, hospitals can focus on preventive care and chronic illness treatment in the community, said Dr. Rachel Levine, the Pennsylvania secretary of health. The model rewards the hospitals for keeping patients healthy and out of the hospital.
“Over time the idea is to devote more resources to population health measures and put less emphasis on trying to fill their beds,” Levine said.
Other measures that Ollove covers in the 2,000-word article:
- A $96 million loan program from Medicare and Medicaid Services “to help establish rural health networks called accountable care organizations.”
- A promise from the Medicare and Medicaid Services administrator to make more changes in how rural hospitals are paid.
- A Michigan legislative proposal to exempt small rural hospitals from some regulation and oversight as a way to reduce costs.
- A Colorado program that allows paramedics to make calls in rural areas to monitor patient care.
- Telemedicine expansions in Idaho, Oregon, Vermont, Washington and Texas.
- Mental health outreach programs in Michigan, Pennsylvania and North Dakota.
In Georgia, state lawmakers are concerned about possible impact Governor Brian Kemp’s budget proposal may have on rural areas (including rural health programs). “Rural Georgia is going to get killed,” says state Representative James Beverly (D) of Macon. The Atlanta Journal Constitution sums up the proposal thusly:
The governor’s budget plan would eliminate funding for a rural water association and a rural health innovation program, cut money for loan repayment awards for health care professionals working in rural Georgia, for medical malpractice insurance assistance for doctors working in rural Georgia, to a rural surgery initiative, to doctor training programs that helped prepare more physicians to work in rural Georgia, and for several other medical programs.
The governor’s office says the budget proposal will keep rural Georgia strong. The plan includes a $2,000 raise for educators (one of Kemp’s campaign promises).
The closing of rural hospitals and specialty care units is causing many people, including breast cancer patients, to seek treatment far from home. A study from the University of Minnesota School of Public Health recently found that U.S. rural breast cancer patients typically travel three times farther than urban women for radiation therapy to treat their disease.
The study was led by Ph.D. student Colleen Longacre and appeared in The Journal of Rural Health.
The study found:
- Patients living in rural areas traveled, on average, nearly three times as far as women living in urban areas for radiation treatment: 40.8 miles vs. 15.4 miles.
- The nearest radiation facility for rural women was, on average, four times farther away than for urban women: 21.9 miles vs. 4.8 miles.
— Excerpted from a University Minnesota press release
Someone drive a stake through the heart of this erroneous “fact.”
For years, we’ve been tracking an erroneous statement made during the Obama years that rural Americans accounted for 44% of the U.S. military. For the tale of the tape, see Bill Bishop’s article from 2011.
The latest recirculation of the error was made by the CEO of a major agricultural cooperative.
It’s understandable, because the misstatement appeared in a Obama-era white paper called “Jobs and Economic Security for Rural America.” The paper is not online anymore.
The actual percentage of military personnel who come from rural America is likely somewhere around 20%. That still means rural military-age residents are more likely to serve in the armed forces than urban ones. But that rate is nothing close to the 44% number.