Main Library
Improving The Health Of Rural Americans

Improving The Health Of Rural Americans

October 13, 2021Stephen M. Shortell, Brent D. Fulton, Leeann N. ComfortNo CommentsHealth AffairsPatient Engagement & Access,Health Equity & Social Determinants of Health (SDOH),ACO Growth and Expansion,Community Health Solutions,Patient Outreach & Communications

People living in rural America have lower incomes, less education, and are in poorer health than those living in other areas of the United States. For more than a century, these measures have been “sticky” with little change despite many efforts to do so.

It is also well-known that most rural areas have a shortage of primary care and specialist physicians and lack of hospital capacity. Since 2010, 138 rural hospitals have closed, leaving approximately 2,300 rural hospitals currently open in the US. Many others are financially distressed. In 2016, 39 percent of rural hospitals had a negative operating margin, increasing to 46 percent in 2020. Inpatient admissions and occupancy rates continue to fall, serving as leading indicators of future closures.

Accountable care organizations (ACOs) and value-based payment reforms targeted to rural hospitals, while necessary, are insufficient to address the underlying challenges of rural health care delivery and improving the health of people living in rural America. A much broader cross-sector approach that addresses the underlying health needs of rural Americans will be needed. The Centers for Medicare and Medicaid Services (CMS) Community Health Access and Rural Transformation (CHART) model and the Accountable Health Communities model are steps in the right direction but do not go far enough. We propose to the Department of Health and Human Services (HHS), CMS, and the private sector the development of Rural Community Health Improvement Systems (RCHIS). In this blog post, we first briefly review the evidence on rural hospital involvement and performance in ACOs. We then suggest a new approach, outlining the main components of the RCHIS and what CMS and others can do to support their development.

Full Article

: Accountable Health Communities, CHART, CMS, community health, Community Health Access and Rural Transformation, patient access, patient communication, RCHIS, Rural, rural America, Rural Community Health Improvement Systems, SDOH

Related Posts

On a mission for social equity

October 12, 2021Garrett Schmitt

Legal and payer changes focus on addressing social determinants of health

April 11, 2022aco

How social determinants of health can enable value-based care

May 7, 2021Garrett Schmitt

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Recent Posts

  • Value-based care creating a new era of interoperability
  • ACO REACH And Advancing Equity Through Value-Based Payment, Part 1
  • Medicare Shared Savings Program: Celebrating 10 Years and Looking Forward to the Future
  • Considerations for Social Determinants of Health Screening Design
  • RECORDED WEBINAR: 5 Key Components for Organizational Growth Within Value-Based Care
 
  • Main Lobby
  • Exhibit Hall
  • Events
  • Exhibit With Us
  • Board Room
  • Library
  • Contact Us