Task force explores models for rural healthcare
Hospitals, health systems, and post-acute care providers from across the nation are committed to improving the access and delivery of essential health care services, but facilities operating in rural and frontier communities face numerous challenges in fulfilling their missions.
Excessive federal regulations and obsolete financing mechanisms add an extras level of stress on rural and frontier health care providers, whose workforce and finances are already limited by factors such as socioeconomic and demographic challenges. Communities experiencing multiple vulnerability characteristics are susceptible to a cumulative vulnerability risk that endangers the sustainability of quality health care services for more than 450,000 individuals – half of our state – living in rural and frontier South Dakota.
To proactively address these issues, the South Dakota Association of Healthcare Organizations (SDAHO) Board of Trustees last fall created the Task Force on Ensuring Access in Vulnerable Communities (VCTF) Rural and Frontier.
The 17-member group, which followed a construct established by the American Hospital Association (AHA), identified the characteristics and parameters of a vulnerable rural or frontier community in South Dakota and studied opportunities for innovation and emerging strategies, delivery and payment models. The task force also explored what state and federal government can do to create a climate for transition to these different models.
Residents of rural and frontier communities should have access to essential health care services, which include primary care, emergency services, behavioral health, dental services, transportation, diagnostics needs, prenatal care, referral and coordination resources and long-term services and community supports. Access to these services is critical for overall physical, mental and social needs, the prevention, detection and treatment of illness. They provide a quality of life and boost life expectancy.
The task force determined that a sustainable rural health care delivery system should focus on the Triple Aim of improving the patient experience, improving the health of populations and reducing the per capita cost of health care for the population served. It should also encompass:
● Prevention, primary care, chronic disease management, and emergency services
● Coordination of the care continuum from wellness to home and community-based services too acute and post-acute
● Providing access to essential health services within a reasonable distance and timeframe
● Encouraging collaboration
● Pursuing technology
● Patient safety and quality
● Fair financing mechanisms by federal, state and local resources, private payers and patients
The task force concluded that the current Critical Access Hospitals (CAH) model is vitally important to maintaining access to high-quality health care services in rural/frontier communities, but a “one size fits all” approach or solution is not advisable, and a number of models have the potential to help ensure access.
The task force recently released its findings in a report that is available at http://www.sdaho.com/vctf.pdf. Health care and community leaders are encouraged to discuss the information with a broad coalition of stakeholders in a “call to action” to engage conversations about the future health care needs in their communities and throughout the state. SDAHO will share the findings with national partners such as AHA, LeadingAge and others in an effort to identify opportunities to influence public policy and legislation that supports positive changes in rural/frontier health care delivery models.
Scott Duke is President/CEO of the South Dakota Association of Healthcare