Rural healthcare’s $50B crossroads: How to rebuild access and sustainability | Viewpoint

The state of rural healthcare in America has moved center stage in recent months thanks to the release of the Centers for Medicare and Medicaid Services’ $50 billion Rural Health Transformation Program.

A growing list of sobering statistics and headlines has caught the full attention of federal governing bodies, with one analyst report suggesting this might be the industry’s singular shot to get it right.

Financial woes are wreaking havoc on all rural health providers. Notably, 30% of hospitals are at risk of closure, potentially leaving wide gaps in care access for millions.

Rural health transformation funding is prioritizing technology implementation and workforce redesign to change current dynamics. The most impactful strategies will target technology-driven solutions that align stakeholders around common goals through a coordinated, collaborative approach to caring for communities. This starts with a unified population health strategy that leverages tech to address the following five key areas.

1. Proactive outreach to close care gaps

Social drivers of health (SDOH) that create barriers to patients receiving the care they need tend to be greater in rural areas. Consequently, proactive outreach that ensures patients keep their appointments and follow through with care plans is critical to getting out in front of avoidable, high-cost health issues.

Automation plays a key role in supporting care teams in reaching patients in a timely fashion, by delivering information such as appointment reminders or notifications for overdue screenings and vaccinations. These strategies have not only proven to reduce no-show rates and enhance preventive care efforts, but they also streamline scheduling processes, freeing up staff to focus on more complex needs.

For example, by automating text-based patient outreach, Valley Professionals Community Health Center, an Indiana-based Federally Qualified Health Center (FQHC), was able to increase childhood immunization rates from 15.7% to 23% in just two years. In the same timeframe, the organization also increased Medicare annual wellness visits from less than 1% to 45% after the pandemic.

Patient communication by text message is particularly important in rural areas due to broadband limitations.

2. Informed, data-driven provider-patient interactions

Research shows that patients in rural communities see their providers less frequently than their urban counterparts. This discrepancy is often linked to the limitations of healthcare resources available and social factors such as access to transportation.

Busy, and often overrun, rural healthcare organizations need tools that help them make the most of their time with patients. Population health platforms that aggregate data from multiple sources can prepare providers for appointments with game-changing information such as status of chronic conditions, overdue screenings, vaccination needs and social factors impacting health. Providers equipped with this information ahead of the visit can then close gaps in care plan adherence.

Care teams leveraging these tools are seeing powerful results. Use of a patient visit planning tool enabled Hawaii-based Waianae Coast Comprehensive Health Center to increase depression screenings from 25% to nearly 60% in one year, as well as improve weight assessment follow-ups in children and adolescents by 34%.

These tools also helped four health centers boost screening rates among patients aged 50–74 from 30% to 49% within nine months, generating an estimated $5.3 million in treatment savings for an Alaska health system.

3. Elevated chronic disease management

One-fifth of the U.S. population resides in rural areas. According to the Centers for Disease Control and Prevention, rural residents are more likely to die prematurely from five of the leading causes of death than their urban counterparts. These include heart disease, cancer, stroke, unintentional injuries and chronic lower respiratory disease.

To get ahead of complications associated with chronic disease, rural providers must first understand the health intricacies of their populations—namely who is at risk. Achieving this kind of in-depth view of a population requires technology that can pull data from multiple sources including EHRs, health plans, and HIEs. With integrated data, providers can leverage advanced analytics to stratify risk and bring appropriate patients into outreach programs.

On the financial side, the right infrastructures can automate performance reporting for payer and regulatory programs, strengthen financial sustainability by supporting participation in Medicaid waivers, value-based programs and payer incentives tied to improved outcomes.

4. Improved integration of behavioral health

Access to behavioral health services is a challenge across all U.S. communities, but rural health faces the most critical shortages of professionals based on need. Any step forward to improving the rural health outlook must consider the important role of integrating behavioral health information into primary care workflows.

Greater collaboration across stakeholders is imperative to help providers identify gaps and initiate screenings for depression, anxiety and substance use during routine visits and appropriately share across providers. This step will help ensure patients receive timely, coordinated mental health support.

5. Streamlined reporting and workflows

Given the existing and projected shortages of clinicians in rural communities, care teams are already over-burdened with trying to meet federal and state quality reporting requirements.

As part of the workforce redesign priorities targeted by the Rural Health Transformation Program, provider organizations will need the heavy lifting associated with reporting requirements removed and the ability to incorporate technology as a core part of the workflow. Technology plays a critical role in making this happen by eliminating manual processes and automating data collection, performance tracking and compliance reporting.

Building a sustainable future for rural health

Equipping providers with the right technology and tools for workflow redesign and proactive outreach are critical steps to ensuring a sustainable future for rural health organizations. Unified population health platforms that bring together needed data and promote greater collaboration provide the foundation needed for building healthier communities.

LuAnn Kimker is senior vice president of clinical innovation for Azara Healthcare.