- Rural healthcare organizations often operate under several major disadvantages compared to their urban and suburban counterparts. Small facilities with shoestring funding and limited access to advanced care providers and technologies have tended to struggle to serve a widely distributed population facing unique socioeconomic challenges.
“Population health management” takes on a completely different meaning when a provider’s attributed patients are spread over several counties and hundreds of miles of mountains or farmland, especially when one single hospital and a handful of primary care offices are their only connection to quality care.
Rural and critical access hospitals have been folding under these pressures at an alarming rate, and the growing shortage of young physicians, many of whom are attracted to the stability of employment in large, integrated health networks, is affecting the nation’s vast countryside at a disproportionate rate.
However, organizations like the USDA, HHS, and the US Health Resources and Services Administration (HRSA) are doing everything in their power to prevent rural populations from falling behind.
HRSA recently announced millions of dollars in grant funding to more than a dozen rural healthcare organizations and academic centers in an effort to expand training and education for healthcare providers, jumpstart population health management programs, and support the delivery of high quality patient care.
Penn State College of Nursing receives $350,000 for advanced practitioner training
Approximately twenty Master of Science in Nursing students will receive funding for their final year of studying to become primary care providers in rural communities thanks to an HRSA grant.
“Students will have clinical experiences in rural areas or other medically underserved communities in Pennsylvania to gain knowledge of providing care to these populations,” said Madeline Mattern, director of the nurse practitioner options in the College of Nursing.
“Eighty-one percent of our 2015 graduates work in medically underserved and/or rural areas in Pennsylvania. This supports our mission of improving access to primary care in these areas.”
The training program is offered at five Penn State campuses, and many graduates will stay in their home communities to care for patients, added Representative Glenn ‘GT’ Thompson of Pennsylvania.
“Rural communities continue to face challenges when it comes to recruiting and retaining qualified nursing professionals,” he said. “Funds made available through this grant will keep nursing students in their hometowns, making a real difference for Pennsylvania’s rural and aging populations.”
Wayne State University to focus on pediatric development and disabilities
Wayne State University in Michigan will use a $2.2 million grant from the HRSA’s Maternal and Child Health Bureau to develop the Leadership Education in Neurodevelopmental and Other Related Disabilities Maternal Child Health Training Program (MI-LEND), a collaborative effort involving six local universities.
The collaboration will focus on the complex needs of children with autism, cerebral palsy, and other disabilities. It will also expand the number of healthcare providers trained to conduct screenings, diagnose young children, and develop treatment plans.
Expanding the educational opportunities related to the treatment of autism and other developmental disabilities for over 181,800 medical and professional students and physicians will help improve the quality of care for these individuals and increase their ability to have self-determined independent lives," said Michigan Lt. Gov. Brian Calley.
Michigan State University, University of Michigan, Western Michigan University, Central Michigan University and University of Michigan-Dearborn will join Wayne State in the consortium.
"This is an important program in the Detroit community and throughout Michigan that will improve the health of our youth that have or are at risk for neurodevelopmental and other related disabilities," said Stephen Lanier, vice president for research at Wayne State University. "Wayne State and its collaborative partners will make a tremendous impact on these children and their families by providing this important program that is committed to diversity and equity."
Sarah Bush Lincoln Medical Center will address COPD and heart failure
With a $565,000 grant in hand, providers at Sarah Bush Lincoln healthcare facilities in Illinois will work to improve population health management and chronic disease management for patients with COPD and heart failure. The funding will be used to help a small cohort of chronic disease patients stay out of the hospital and maintain a high level of wellness.
“We are terribly excited about this opportunity,” said SBL Care Coordination Director Carol Ray, RN. “By caring for this select group of people, who typically experience unplanned hospitalizations, we hope to learn from the process and apply the principles to other locations and to people with other illnesses.”
The program will include assessments of patient engagement and self-management skills, and will also focus on improving medication management and meeting clinical quality measures.
“Helping patients determine and share their priorities can increase their motivation to make healthy changes,” Ray said. “Someone may not be motivated to adhere to a program in order to be well enough to take a long trip, but may be motivated enough to make changes to attend a grandchild’s wedding. People have different triggers and we need to uncover those to help them achieve their health goals.”
University of Arizona Center for Rural Health supports patients across the state
The federally designated State Office of Rural Health at the University of Arizona will take advantage of $860,000 in HRSA grant funding – matched by $2.58 million from the state – to improve population health management and rural healthcare across Arizona during the next five years.
"Arizona and our nation face great challenges in transforming our health system to improve health outcomes, enhance access to high-quality and cost-efficient health care, and assure coverage of health services,” said Dr. Daniel Derksen, professor and chair of the Community, Environment and Policy Department, and director of the Center for Rural Health. “This funding will allow us to leverage support to improve rural health care in Arizona."
The funding will be put towards establishing a centralized location for collecting and sharing information on rural healthcare issues, research results, and innovations, as well as coordinating care to reduce inefficiencies.
"Access to quality and affordable health care should not be determined by where you live," said Jennifer Peters, the center's rural program manager. "The center and our State Office of Rural Health program have been a long-serving and consistent voice for Arizona's rural health care system, including the most geographically isolated and underserved communities in the state."
University of California at Riverside receives $2.3 million to expand primary care workforce
A five-year Primary Care Training and Enhancement grant from HRSA will help the School of Medicine build more robust community relationships and address the needs of medically underserved patients in California’s inland regions.
“We will deploy a research curriculum to equip medical students, residents, practicing physicians, and pharmacists with the population health skills needed to address inland Southern California’s poor chronic disease metrics and healthcare disparities,” said Michael Nduati, MD, associate dean of clinical affairs in the School of Medicine.
“We will expand the pipeline of future healthcare leaders through longitudinal interprofessional training. We also will ground lifelong faculty development into a new, integrated model of healthcare training towards improving the delivery of care to the inland Southern California community.”
Primary care, coordinated team-based service delivery, and population health management play a major role in the new medical school’s guiding vision, Nduati added. The first class of medical students will graduate in 2017.
“We train across a spectrum, linking medical students to residents and to attending physicians – this creates higher yield practice improvement projects and promotes a culture of continuous quality improvement, leading to better and more efficient health care,” he said.
“This generous grant should help us see great improvements soon in the efficiency and efficacy of health care provided to our population.”