The healthcare needs of rural residents foretell a future where social determinants of health become poorer and medical care access becomes further diluted without direct intervention. Social determinants of health factors that fall behind state and national averages combined with shifts in national healthcare policy and c.hanges in reimbursement have resulted in significant challenges in the sustainability of the current healthcare structure in rural Colorado.
The country’s long-standing approach to healthcare delivery has created fragmented healthcare systems, facilities, providers, payors and regulators, causing challenges for the general healthcare consumer, and continues to further compromise the rural consumer experience. Initiatives and funding for programs that address these concerns are widely unavailable to rural communities, as priorities are largely based on the population of impact, favoring more urban communities with larger service volumes. These challenges directly impact the sustainability of our rural hospitals leaving few options for providers to remain in service resulting in hospital closures or acquisition by urban health systems. The economic and cultural implications of losing hospitals to closure or urban systems are dire to the sustainability of the communities. The healthcare industry is among the leading economic drivers in many rural communities. The jobs and revenue that are reinvested in these communities are a large part of keeping their neighborhoods alive.
Eastern Plains Healthcare Consortium (EPHC) is a network of rural health providers across the eastern plains of Colorado that aims to address these boundaries and challenges by banding together and sharing resources. Through the sharing of physical and intellectual resources EPHC is able to create additional capacity for each network member to further engage in population health management activities and needs, beyond those regulated, while maintaining their independent facilities and operations specific to each of their unique communities.
EPHC was created to address common barriers that rural healthcare providers experience when addressing access to and quality of healthcare services sensitive to cost and sustainability. The activities of the network will focus on (1) implementing innovative solutions to alleviate the loss of local services and enhance access to care for communities that may have or at risk of losing their local hospital; (2) leveraging competitive negotiations and contracts with Qualified Health Plans (QHPs) through Essential Community Provider (ECP) collaboration; (3) implementing programs to increase primary care workforce in rural areas; and (4) expanding access to outpatient cardiology and/or pulmonary rehabilitation, speech therapy, child psychology and other critical shortages.
Initiatives for 2019 include launching staff sharing protocols to allow sharing of critical staff across the network to fill shortages and treatment gaps, create centralized training programs for Certified Nursing Assistants, implement supply share and order programs for the network to capitalize on large order discounts and reduce waste across the network, pharmacy resource sharing, develop continuing education programs for network providers, launch telehealth services for behavioral health to reduce threat of stigma from the community and tackle contract negotiations to improve fee for service contracts.