1. Innovations in Rural Health Care Environments
Dr. Bob Moser, M.D.
Executive Director, Kansas Heart and Stroke Collaborative
University of Kansas Hospital

2. Current State of Rural Health

3. Rural Health Rural Health Issues Relationship?
higher prevalence of obesity,
higher rates of cancer, heart disease, and diabetes
higher injury-related deaths, and
higher prevalence of chronic conditions
Relationship?
insufficient healthcare resources, difficulties in accessing healthcare, and physician shortages.

4. Rural Health Outcomes

5. The Population of Kansas is Changing
One- Kansas has areas of intense population concentration. These areas that are growing will experience new challenges that we need to be mindful of as we identify priorities. And while much of our population resides in just a handful of our counties, we are tasked with developing a plan that will benefit all Kansans in all counties regardless of size and consider distances between services, transportation issues, and population demographics.
This group will continue to increase moving from 13.3% of our population in 2000 to 20.2% of the population in But we also see illustrated in the projections for 2030 a more equal distribution across age groups. These projections are helpful as we think about priorities and how we best allocate resources.
And Third- the makeup of the Kansas population is changing. During the last decade the Hispanic population grew nearly 65% (now represent about 11% of the total population) and the Asian community by nearly 55% (now represent about 3% of the total population).
Recognizing these changes and adequately planning for them as we develop themes and identify priorities will serve to strengthen our overall plan.

6. Consider the challenge of supporting the aging populations in some of our counties, when those over 65 years of age make up a significant percentage of the population, especially when looking at those supporting service needs, tax base contributions, and competing services –such as schools and daycare..

7. Rural Health Care Delivery
Hospital
Traditional Structure and Operations
Determined by Conditions of Participation from CMS and state law/rules/regulations
Full Service PPS or
Critical Access Hospital
What will the “Hospital” of the future look like in rural America?
Local Need & Support may dictate changes
Free Standing ER + Clinic + LTC or any combination
ER (from minor events to major trauma and CBRNE events)
OB (Labor/Birthing rooms, Surgical Delivery, Nursery, Security)
Outpatient Procedures (endoscopy, minor surgery)
Surgery
Adult and Pediatric Medicine
Geriatric
Rehabilitation
Lab/x-ray/CT Mobile units
Front and Back Office services

8. Rural Health Care Delivery
Clinic
Traditional Structure and Operations
Determined by Conditions of Participation from CMS and state law/rules/regulations
Full Service with Independent or Employed Providers
Rural Health Clinic (provider based or independent)
Staffing (physicians and/or non-physician providers
What will the “Clinic” of the future look like in rural America?
Local Need & Support may dictate changes
Free Standing ER + Clinic + LTC or any combination
ER (from minor events to major trauma and CBRNE events)
OB (Labor/Birthing rooms, Surgical Delivery, Nursery, Security)
Outpatient Procedures (endoscopy, minor surgery)
Surgery
Adult and Pediatric Medicine
Geriatric
Rehabilitation
Lab/x-ray/CT Mobile units
Front and Back Office services

9. Current and Future Considerations
Population density and demographics
Health Issues
Access to care
Distance
Skill set of providers
Service Lines of Care
Technology
Health Care Reform
Community/Population Health
Costs vs Revenue pressures
Community or Population Health Focus evolving