Rural Healthcare Ann Schlueter Community Hospital-Fairfax Missouri Farm Bureau

Community Hospital-Fairfax Atchison County, Missouri

Our Health 25% of the population and 10% of physicians live in rural areas Rural Americans are less likely to have employer based insurance, and more likely to have Medicaid, Private Pay or Medicare Rural residents have greater transportation difficulties reaching health care providers, often traveling great distances to reach a doctor or hospital.

Our Health Rural Americans are 7% more likely than urban Americans to describe themselves as having fair to poor health 2,157 health professional shortage areas are in rural areas compared to 901 in urban areas 20% of rural regions lack access to mental health providers compared to 5% of urban areas 470 rural hospitals have closed in the last 25 years

What is a Critical Access Hospital (CAH)? Critical Access Hospitals are hospitals certified to receive cost-based reimbursement from Medicare. Critical Access Hospitals must be located in rural areas and must meet one of the following criteria: ▫They must be over 35 miles from another hospital, or ▫They must be 15 miles from another hospital in mountainous terrain or areas with only secondary roads.

Obama Administration CAH Recommendations Though sequestration was recommended to end in the 2016 Presidential budget, that doesn’t apply to CAHs Presidential recommendations to Congress included $2.1 billion in cuts from CAHs in 2016 Gave the Centers for Medicare and Medicaid the authority to strip hospitals with CAH designation that are within 10 miles from another hospital

Physician Shortage *Statistics Provided by American Association of Medical Colleges

American Association of Family Physicians

What can We Do-The Stuff You Already Know. Support provisions in our state and from the federal government that support loan repayment and forgiveness for location to rural areas for physicians. Support provisions that aid the expansion of residency programs, especially in primary care. Support the expansion of telehealth services and the ability of physicians to cross state lines and provide telehealth.

What Can We Do?-The Stuff You Already Know Oppose provisions that require more physician supervision in rural areas. Where it is medically appropriate for mid-level providers to be used, we need to give providers that opportunity. Become active in our local communities encouraging our youth to attend medical school, consider family practice, and creating programs to “grow your own.”

Consider New Models of Care Population Health-How do rural healthcare providers leverage our position-close to the patient- in a population health management model? How do we use our agility (small boat) to collaborate with other rural communities to possibly capture savings from a value based model? How do we use the provider resources available to us in a non traditional way to maximize their scarcity?

In Conclusion “The things done in these remote places make life better in cities. The food in restaurants and supermarkets, the material to build homes, the fuel for power plants, and even cars come from outside urban and suburban America. TMH serves the people who provide so much for America” Edwin Leap MD, The Sick and Dying Found in Hospitals of Any Size.