Health of Our People: Policy Recommendations
Four key principles should guide legislative action:
- Flexibility in financing and program rules is required to encourage and enable responsiveness to local needs and to promote innovation in service delivery to different populations and communities.
- Tackling the shortages of health-care professionals in rural areas requires openness to creative responses while ensuring quality patient care.
- Access to broadband communications throughout rural America is a prerequisite for the adoption of health information technologies that are themselves crucial to achieving quality and affordable health care.
- Collaboration across health-care providers and between health-care and other sectors, both at regional and local levels, is critical to making the best use of limited resources and to fostering creative responses to diverse community needs.
The National Rural Assembly recommends the following policies in four priority areas:
Quality Health-Care Workforce
We must enhance programs that recruit and maintain a quality health-care workforce, including physicians, nurses, dentists, pharmacists, and other health-care professionals.
Recommendations:
- Support and expand upon programs such as the National Health Services Corps, HRSA Health Profession programs, and state-based loan repayment programs.
- Expand and permanently reauthorize the J-1 visa program to encourage international medical graduates in rural areas.
- Support the upcoming reauthorization of Titles VII and VIII of the Public Health Services Act in order to develop educational programs to train qualified health professionals for rural clinics, practices, and hospitals.
- Encourage collaboration among practitioners to meet regional pharmacy needs. Use videoconferencing and other technologies and targeted training programs to recruit and retain pharmacists in rural areas.
- Allow new workforce initiatives to be applied in creative and flexible ways to address patient care in areas of professional shortages.
Flexibility in Health-Care Finance Policy
Changes in health-care finance policy must be made to address the needs of rural America.
Recommendations:
- Ensure that the ongoing debate over health care reform recognizes the rural-specific challenges in health-care delivery.
- Enhance programs that support flexibility in financing and reimbursement schedules for Medicare and Medicaid, for instance, Critical Access Hospitals.
Innovative Programming in Health-Care
Delivery and Healthy Behavior
We need to invest in new and innovative programs, particularly those that have the potential to improve health-care delivery in rural communities and promote healthy behaviors.
Recommendations:
- Continue efforts to make sure all Americans are connected to an electronic health record by expanding broadband and information technologies to rural America, and ensuring that policies and financing adequately address post-implementation needs.
- Develop policies that allow the use of innovative models for coordinating health-care delivery in rural areas, for example, the “medical home” – a system of care that helps families navigate the many complicated elements of health-care, such as prevention, appointments with specialists, interaction with schools and workplaces, counseling, community resources, and others.
- Create community-wide partnerships, integrated with health-care services, with the goal of improving health in communities as well as individuals.
- Design policy strategies that meet the Institute of Medicine’s goal of quality improvement, aiming for health care that is safe, effective, patient-centered, timely, efficient, and equitable.
Caregiver and Veteran Programs
Programs that support family caregivers and veterans must be developed and given the support they need to succeed.
Recommendations:
- Expand existing caregiver assistance programs to a sufficient level to provide needed support to caregivers.
- Support the Rural Health Initiative introduced in 2008 and similar initiatives that provide services and programs to rural veterans.
