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Rural Reality: More Coverage, Enough Care?

Friday, July 26, 2013

 Sixty-two million Americans live in rural areas and they have higher rates of mortality, disability and chronic disease than their urban counterparts. With high poverty and unemployment rates, low rates of health insurance coverage and an undersupply of health care providers, the ills of the health care system are especially notable in rural communities. The Patient Protection and Affordable Care Act (ACA) contains provisions relating to access to care, coverage and delivery system reform. But the impact of these provisions is uncertain in rural America, with its unique challenges.

What provisions in the ACA address rural health care challenges? How key is Medicaid in access to care in rural areas? Will the health workforce be sufficient to meet demand when coverage expands? How can recruitment and retention challenges be met? What role will state practice acts and licensing play in the use of allied health professionals and in the delivery of telehealth services?

A distinguished panel of experts addressed these and related questions.

Keith Mueller, director of Rural Policy Research Institute (RUPRI's) Center for Rural Health Policy Analysis, provided an overview of rural health issues, what's in the ACA to address them and what challenges remain.

Tom Morris, director of HRSA's Office of Rural Health Policy, offered an update on federal rural initiatives that aim to strengthen the workforce and enhance access to health care.

Art Kaufman, vice chancellor for community health sciences at the University of New Mexico Health Sciences Center featured the center's community health focus through a program of academic extension hubs. He highlighted the role of community health workers and outcomes in Native American communities.

Lisa Miller, former member of the Maine House of Representatives, talked about challenges that state legislatures and executives face in serving rural populations, including scope of practice and licensure.

Ed Howard of the Alliance and Zane Yates of Centene moderated the discussion.

Contact: Marilyn Serafini 202/789-2300

The event was sponsored by the nonpartisan Alliance for Health Reform and The Centene Corporation.

Event Summary and/or Webcast and Podcast

Full Webcast/Podcast: Video recording from C-SPAN

Speaker Presentations

Miller Presentation (Adobe Acrobat PDF), 7/26/2013
Morris Presentation (Adobe Acrobat PDF), 7/26/2013
Kaufman Presentation (Adobe Acrobat PDF), 7/26/2013
Mueller Presentation (Adobe Acrobat PDF), 7/26/2013

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), , 7/26/2013
Speaker Biographies (Adobe Acrobat PDF), , 7/26/2013
Selected Experts (Adobe Acrobat PDF), , 7/26/2013
Materials List (Adobe Acrobat PDF), , 7/26/2013

Offsite Materials (briefing documents saved on other websites)

The Uninsured: An Analysis by Income and Geography, Rural Policy Research Institute, 7/1/2013
Health Care Workforce Distribution and Shortage Issues in Rural America, National Rural Health Association, 1/1/2012
Is GME Snubbing Rural America?, HealthLeaders Media, 6/19/2013
Pennsylvania starting to close rural health centers, furlough nurses, Pittsburgh Post-Gazette, 5/29/2013
Campbell’s new medical school strives to fill rural health care needs, The Fayetteville Observer, 6/16/2013
Community Health Workers and Medicaid Managed Care in New Mexico, Journal of Community Health, 9/28/2011
Accountable Care Organizations in Rural America, Rural Policy Research Institute, 7/1/2013
Bill would help rural veterans access VA services, Navy Times, 6/21/2013
Tom Morris Testimony before the United States Senate, Committee on Homeland Security and Governmental Affairs, Subcommittee on the Efficiency and Effectiveness of Federal Programs and the Federal Workforce, 5/23/2012
The Current and Future Role and Impact of Medicaid in Rural Health, Rural Policy Research Institute, 9/1/2012
NHSC Clinician Retention: A Story of Dedication and Commitment, National Health Service Corps, 12/1/2012
Options for Rural Health Care System Reform and Redesign, National Advisory Committee on Rural Health and Human Services, 12/1/2012
Missouri law may boost health-care access in rural areas, Southeast Missourian, 6/25/2013
Rural America Will Benefit from Medicaid Expansion, Center on Budget and Policy Priorities, 6/7/2013
The 2011 Report to the Secretary: Rural Health and Human Services Issues, The National Advisory Committee on Rural Health and Human Services, 3/1/2011
The Redistribution Of Graduate Medical Education Positions In 2005 Failed To Boost Primary Care Or Rural Training, Health Affairs, 1/1/2013
The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look, Rural Policy Research Institute, 9/16/2010
Small, Nonteaching, And Rural Hospitals Continue To Be Slow In Adopting Electronic Health Record Systems, Health Affairs, 5/1/2012
Health Extension: Learning from Farmers How to Improve Community Health, TEDxABQ, 9/1/2011
Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease, Annals of Family Medicine, 1/1/2010
Rural Health Issues: Implication for Rural Healthy People 2020, National Rural Health Association, 1/1/2010
Rural Healthy People 2020, The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center, 7/17/2013
The Adoption and Use of Health Information Technology in Rural Areas: Results of a National Survey, The Journal of Rural Health, 3/18/2011


30 percent of the people in New Mexico who are currently eligible for Medicaid are not on Medicaid, Art Kaufman, vice chancellor for community health sciences at the University of New Mexico Health Sciences Center, stated at a July 26 Alliance for Health Reform briefing, Rural Reality: More Coverage Enough Care?


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