Rural health leaders gather to worry about reform

If you take 400 or 500 rural hospital administrators, doctors, nurses, public health officials, teachers and others and put them in a room, what are they going to talk about?

We'll find out for sure later this month in Duluth when the annual Minnesota Rural Health Conference takes place. But there's a pretty good chance you'd hear some agitation over national health care reform and the fear that, no matter what you think of the debate in general, it's going to have some unintended consequences for small town health care.

Two cases in point: The national law promotes the use of "accountable care organizations" to handle patients' care in a more networked way, spreading the responsibility for care among a variety of providers. It also encourages the use of electronic medical records.

Both have the potential to save money and make care better. But a lot of people heading to Duluth June 27 and 28 will tell you the burden of paying for those two provisions falls unduly on small -- i.e., rural -- providers that have less opportunity to spread costs around.

"We're really concerned about it," says Terry Hill, executive director of the National Rural Health Resource Center, which is helping put the conference on.

[image]

As always, a variety of winds are sweeping across the rural health care landscape, and the new federal law is only one. Here at Ground Level, we're planning to launch a package of coverage on Minnesota's rural health care on Monday, both on the air and here online. It will deal with a lot of what the folks meeting in Duluth a week later are thinking about.

When organizers asked those planning to attend what concerned them, the largest group said "adequate workforce," including everything from doctors to technology whizzes. That's a longstanding issue, but it has gotten harder and more complicated. Twenty years ago, for example, hospitals didn't need to have IT experts at the ready to make medical records talk to each other. Now they do.

The survey of attendees reveals some interesting philosophical differences when it comes to the roles of business and personal responsibility.

One person was concerned that the trend toward affiliations with larger companies would leave communities out in the cold. Another saw a positive in the regional health care firms, worrying about losing the personal touch of rural health care but approving of the ability to stay alive.

Said another:

"I struggle with the concept of accountability being placed on the providers and none placed on the patient. I think there is an enormous need for much greater patient accountability for their own health.

But there was a counterpoint from another:

"The current 'tea party' culture of 'every man for himself' is very troubling to me. Rural people especially understand the critical need to band together for the common good. Do people understand that taxes are turned around into grants and low interest loans, loan forgiveness programs, etc. that will in turn benefit the lives of their families and friends? Or don't they care at all?"

So clearly, rural health care people have some common interests but -- is this a surprise? -- when you put a few hundred of them in a room, there ought to be some lively debate going on.

• Annandale watches special session for broadband help
• DNR pushes ahead with its groundwater planning
• Broadband providers seek $44 million from state fund
• Shifting rain could be lowering groundwater