Topics: Healthcare business and finance

Rural Health Clinic Program at 45 Years: Created for Access and Still Delivering Care

After a 1965 public law created the Medicare and Medicaid programs, many rural residents insured by these government health programs were unable to access care. This challenge was remedied by another public law: the Rural Health Clinic Services Act of 1977. Using a historical framework, rural health policy experts, researchers, and clinicians reviewed the Act’s impact on outpatient healthcare delivery in rural America.

Over 5,200 rural organizations participate in the Rural Health Clinics program, a reimbursement model dedicated to rural low-volume healthcare delivery and now in its 45th year. The National Association of Rural Health Clinics — in its 30th year — is a membership organization that emerged as the program increased its participants. Bill Finerfrock, association cofounder and its recently retired executive director, shared the group’s origin story as well as touchpoints from his own career.

As vice president for research, innovation, and evaluation at Texas-based Episcopal Health Foundation, Shao-Chee Sim, PhD, discusses how philanthropic organizations can make small rural research investments — and, in particular, leverage cross-funder collaboration — that impact not only funders themselves, but also healthcare delivery systems and the rural Americans they serve.

Dr. Clint MacKinney explains the challenges rural hospitals face with current payment systems and the potential that value-based payment holds for meeting rural communities’ needs.

The greatest opportunity to tell the rural healthcare delivery story is an opportunity often missed — and that opportunity involves translating clinical documentation into medical codes. In addition to describing how the story and quality of clinical care gets translated from words into alphanumeric numbers, medical coding experts also pointed to aligned efforts to familiarize those in graduate medical education settings with the impact of their clinical documentation.

Clinical psychologist and program director for the Great Plains Telehealth Resource & Assistance Center, Dr. Jonathan Neufeld, clarifies telehealth as an “enabler” of healthcare delivery. Emphasizing that telehealth is only a set of telecommunication tools, he details how the unique use and flexibility of these tools by skilled providers can bring quality care and impact rural health equity.

It’s a crisis: rural hospital closures. Helping at-risk hospitals thrive in order to continue to serve their communities, Texas A&M’s Center for Optimizing Rural Health (CORH) offers technical assistance through a federally funded program for vulnerable hospitals. The CORH team and an Oklahoma program participant share specifics on just how the program’s assistance can help keep doors open.

“Swing bed” is that oft-heard phrase describing not a physical hospital bed, but post-acute care for the rural patient who is well enough to leave the acute care hospital but not well enough to be safe at home. In this 2-part story, experts and hospital administrators review the swing bed program’s historical implementation and provide stories and examples of the value this over 40-year-old healthcare delivery and reimbursement model brings to patients, to the hospitals providing their care, and ultimately to rural communities.

The healthcare delivery model known as the swing bed program has allowed rural and Critical Access Hospitals to serve patients by keeping them in their rural communities for post-acute care. Reviewing the history of this program, experts describe early implementation and key program elements that have sustained its success for over 40 years.

Advance care planning — planning for decision-making in times of medical crisis — has always been intended for all people, all ages, with or without a chronic disease. Clinicians talk about the challenges of these conversations now that COVID-19 has nudged planning from the realm of the theoretical future to current reality.

The Rural Monitor

Articles and resources on key rural health issues, from the Rural Health Information Hub

Topics: Healthcare business and finance

Rural Health Clinic Program at 45 Years: Created for Access and Still Delivering Care

A Career of Influencing Rural Healthcare Delivery: Bill Finerfrock and the NARHC Origin Story

Philanthropy, Cross-Collaboration, and the Ecosystem That Is Rural Healthcare Delivery: Q&A with Dr. Shao-Chee Sim

Let’s Get a Good Deal on Health Care

Understanding the “Tool-ish-ness” of Telehealth: Q&A with Dr. Jonathan Neufeld

Keeping the Doors Open: Vulnerable Rural Hospitals Benefit from Federally Funded Technical Assistance

History of the Swing Bed: A Look Through the Rural Rearview Mirror

Advance Care Planning: New Realities in Times of COVID-19