June 17th, 2013
The author is director of health policy at Foundation for a Healthy Kentucky.
On May 7, the Foundation for a Healthy Kentucky and the Kentucky Rural Health Association (KRHA) convened the Doing Care Differently in Rural Kentucky health policy conference. This one-day event, held the day before the National Rural Health Association’s annual meeting in Louisville, had more than 100 professionals in attendance. The event addressed key health policy issues through a rural health lens. Topics included the evolving roles of providers in rural health care delivery, telemedicine, Affordable Care Act implementation, and the changing responsibilities of local public health departments in rural Kentucky.
The day started with remarks from foundation CEO and president Susan Zepeda and KRHA Board President David Gross, who introduced the first-ever KRHA executive director, Tina McCormick. Craig Blakely, dean of the University of Louisville School of Public Health and Information Science, provided welcome remarks, noting that rural communities need organizations that can represent their interests to federal and state policy makers.
Keynote speaker, Wayne Myers, a national rural health expert who in the past has directed the federal Office for Rural Health Policy and is a past president of the National Rural Health Association, focused on the work of rural hospitals: “The old model hasn’t been working; it’s time for a new role for hospitals and other providers in rural communities,” said Myers, noting that “small hospitals must change from sick houses to centers of health.” In his presentation, Myers provided a new vision of a community hospital—rooted in health promotion, disease prevention, and rehabilitation services.
Medicaid expansion was featured prominently throughout the day, with Myers noting that “Medicaid expansion has a big health impact.” Three days after the conference, Gov. Steven Beshear (D) announced that the Commonwealth of Kentucky will expand Medicaid to provide coverage for adults up to 138 percent of the Federal Poverty Level.
While acknowledging the need to address health care costs, Myers spoke of the necessity to shift the health policy conversation from cost to health impact. He mentioned that research from Harvard University showed that one life was saved for every 176 people added to the Medicaid program—this, he suggested, is the real argument for expanding Medicaid.
Rural populations face higher poverty rates and face greater challenges in health access and outcomes. The overall rural population is declining, standing at 16 percent of the total U.S. population, according to data that Myers cited.
Alarmingly, life expectancy in rural areas is declining—in sharp contrast with overall U.S. life expectancy. People in rural communities are dying on average at a younger age than their urban counterparts, and they are dying younger than previous generations did, data that Myers cited show. This shrinking rural population translates to decreased “political clout.” Read the rest of this entry »