Fact Sheet
FOR IMMEDIATE RELEASE
Jan 13, 2006 |
Contact: HHS Press Office
(202) 690-6343
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HHS PROGRAMS TO PROTECT AND ENHANCE RURAL HEALTH
Overview: Individuals living in rural and isolated areas face special challenges in receiving timely, quality health care. These areas often suffer from shortages of physicians and other health care providers, and the costs of providing quality health care in a rural health infrastructure can extend beyond available resources.
HHS agencies serve the health needs of rural Americans through programs to strengthen the nation's overall rural health care system. The department encourages health care professionals to serve in rural areas, funds community and migrant health centers to help underserved communities, and supports rural hospitals and state-level coordination and planning to improve and strengthen the rural health infrastructure. HHS also supports initiatives designed to address the special needs of minorities living in rural America and the application of technology capable of bringing health services to people in isolated areas. Finally, the department conducts policy research to investigate how the federal government can work with partners on the national, state and local levels to develop and enhance solutions to the challenges of rural health.
Background: Of the 60 million rural Americans, more than 20 million rural residents have inadequate access to health care services. Nearly half of rural Americans have at least one major chronic illness, yet rural residents average fewer physician contacts per year than those in urban communities. In addition, rates of alcoholism and drug abuse are the same as in urban areas. The serious lack of mental health and substance abuse professionals, community-based services and infrastructure means that, in rural areas, individuals with a mental or substance abuse disorder often go undiagnosed and untreated.
Shortages of health facilities, physicians, nurses and other health care professionals in rural and isolated areas can result in individuals forgoing preventive medicine and necessary health treatment. Coupled with these shortages is the reality that many rural Americans face increased health problems associated with poverty, including high rates of chronic disease and infant mortality.
The Medicare Prescription Drug, Improvement and Modernization Act (MMA) serves as a catalyst in rural communities increasing access to hospitals, health professionals and other services. This Act will increase Medicare spending in rural America by +$25 billion over ten years - providing substantial additional funding for both rural hospitals and other rural health providers. Medicare reimbursement is particularly important for rural communities because people over 65 make up a greater share of their population. The prescription drug benefit is especially important for the one in four Medicare beneficiaries living in rural areas. They are far more likely to lack prescription drug coverage than urban beneficiaries.
HHS PROGRAMS TO PROTECT RURAL HEALTH
HHS' Office of Rural Health Policy (ORHP), located within the Health Resources and Services Administration (HRSA), has primary responsibility for coordinating the department's efforts to support, sustain and enhance local health care delivery systems in rural areas. Programs administered by ORHP, as well as other HRSA bureaus and HHS agencies, provide research and technical assistance, education and placement of health professionals, and funding opportunities to improve rural health care. More information on ORHP and HRSA can be found at: www.ruralhealth.hrsa.gov and at www.hrsa.gov .
In addition, HHS programs work to meet the health needs of racial and ethnic minorities in rural areas, to address substance abuse and mental health problems frequently untreated in rural areas, and to research and promote the use of new technologies to improve access to health care services.
IMPROVING THE PROVISION OF SERVICES AND STRENGTHENING THE RURAL HEALTH INFRASTRUCTURE
Encouraging health providers to serve in rural areas. HRSA administers the National Health Service Corps (NHSC), a program created in 1970 to fill a need for primary care clinicians in rural communities and inner-city neighborhoods designated by the department as health professional shortage areas. The NHSC encourages health professionals to spend all or part of their careers serving the nation's neediest people. The NHSC field strength reached more than 4,000 in FY 2005; 60 percent of those NHSC health care professionals serve in rural areas. The Corps offers scholarships and repayment of student loans in return for providing service in underserved areas. As a continuing Presidential Initiative, the NHSC was able to support more than 1,200 new loan repayment awards and approximately 164 scholarship awards in FY 2005. In addition, the department targets efforts to strengthen the nursing workforce in rural areas by supporting 27 Advanced Education Nursing Program projects, 14 Nurse Education, Practice and Retention Program projects, and 11 Nursing Workforce Diversity Program projects with a rural focus.
Funding health centers in rural America. HRSA funds about 3,700 health center sites across the nation, half of which serve patients in rural areas. Health centers provide access to family-oriented preventive and primary health care services for people living in medically underserved communities. More than 13 million Americans were treated in health centers in 2004.
Leading through community-based organizations to improve health care and targeting efforts to strengthen rural hospitals. Communities themselves, with the support of the department, are best equipped to uncover the needs of their residents and decide how to meet them. In addition, a financially stable hospital is crucial to a community's health as well as its economy - especially in rural areas. Hospitals not only provide residents with essential health care services, they are also a major employer and help fuel the local economy.
Supporting state offices to improve rural health care systems. ORHP administers a matching grant program that has enabled the creation of State Offices of Rural Health in all 50 states. Their mission is to help rural communities build stronger health care delivery systems by collecting and disseminating information, providing technical assistance, helping coordinate rural health interests statewide, and supporting efforts to improve the recruitment and retention of health professionals.
Administering grant programs that support local improvements in rural health. HHS offers grant programs administered by ORHP to help strengthen the health infrastructure in rural and isolated areas:
- The Rural Health Services Outreach grant program awarded $51.5 million in FY 2005 for demonstration projects to strengthen fragile rural health services and address barriers to health care access within rural communities. The program enables communities to design and implement projects that are specifically tailored toward their populations' unique health needs. Rural communities have used the grants to create hospice care, establish school health clinics, provide prenatal care, and train paramedics.
The Rural Health Network Development grant program provided $6.9 million in FY 2005 to help rural providers form partnerships and share resources in formal, integrated health care networks. This program's goals include improving health care delivery systems and encouraging financial sustainability in order to make available a broad range of health services in rural communities.
Directing efforts to meet women's health needs. HRSA's Office of Women's Health and ORHP are coordinating a rural women's health strategy to address the health needs of rural women. One component of this strategy is to support coordination between state offices of rural health, women's health and minority health to improve access to services for all women. Another priority is analyzing data about women's health in rural communities in order to better target services to meet the needs of women.
Researching and supporting technology to improve rural health. Distance can be a substantial barrier preventing residents of rural and isolated areas from accessing the care they need. In 1998, HRSA established its Office for the Advancement of Telehealth to expand the agency's telemedicine and distance learning programs and extend state-of-the-art health care and information to the nation's most isolated and poorest communities.
CONDUCTING RURAL HEALTH POLICY RESEARCH AND COORDINATION
ORHP staffs the National Advisory Committee on Rural Health, a 16-member citizen panel of national health experts that makes annual recommendations to the HHS Secretary for specific rural health care strategies.
ORHP reviews CMS' Medicare and Medicaid regulatory proposals that have a potential impact on rural providers and beneficiaries to offer comments and suggestions on how they may be improved.
ORHP sponsors research on rural health services through the Rural Health Research Center Program. As the sole federally sponsored research centers with a rural-only focus, these eight centers study critical concerns facing rural communities in their quest to secure adequate, affordable, and high-quality health services. Their research examines rural aspects of Medicare and Medicaid benefits and financing, quality of care, disparities, health workforce, mental health and substance abuse issues. Research findings are used to inform a wide audience of national, state and local decision-makers concerned with rural health issues. The eight centers have cooperative agreements with ORHP for fiscal years 2004-2008.
ORHP also supports the Rural Assistance Center (RAC). This free service provides customized responses to inquiries about rural health care and human services, federal and private funding programs, statistics and research. The center maintains extensive resources on Web at www.raconline.org.
The Institute of Medicine (IOM) of the National Academies published a report on quality health care in rural areas, supported by contributions from ORHP, AHRQ, SAMHSA, and W.K. Kellogg Foundation. The report, "Quality through Collaboration: The Future of Rural Health," was released in November 2004. This report is part of a series of reports from IOM pertaining to improving the quality of healthcare, which began in 2000 with the IOM publication "To Err Is Human: Building a Safer Health System." The "Quality through Collaboration" report developed a five-pronged strategy to address the quality health care challenges in rural communities. These strategies include a focus on personal and population health, establishing a rural quality infrastructure, enhancing human resource capacity, ensuring financial stability, and investing in information communication technology.
Finally, to more effectively understand the special circumstances of rural providers and beneficiaries, in 2001 CMS launched a Rural Health Open Door Initiative. Under this initiative, CMS representatives host monthly meetings with rural providers to discuss and review the impact of Medicare and Medicaid regulations on rural health. CMS continues to work closely with ORHP and the private National Rural Health Association to pursue a variety of efforts to understand the impact of Medicare and Medicaid policies on the rural health infrastructure.
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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.
Last Revised: February 21, 2006
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