Bridging the Health Equity Gap in Rural America Through Exceptional Provider Support
*This article was originally published in Becker’s Payer Issues: Bridging the Health Equity Gap in Rural America Through Exceptional Provider Support (beckerspayer.com)
About 60 million people—nearly one in five Americans—live in rural areas and depend on their local hospitals for care. But rural American health care is fragile business.
Across the U.S., 191 rural hospitals have closed since 2005 and nearly a quarter of the country’s rural hospitals are vulnerable, according to the Cecil G. Sheps Center for Health Services Research.
The numbers add up to an enormous health care gap, making rural Americans one of the largest medically underserved populations in the country.
In this article, we delve into the realities of rural health care, the fragility of rural health centers and how one company is bridging the gap by providing exceptional support in areas providers need most.
Why Keeping Rural Health Centers Open Matters
Preserving rural health centers makes business sense across the health care industry. People are healthier when they have access to care, and keeping preventive services available helps individuals maintain their health and avoid costly illnesses.
Access to care helps individuals address health issues before they become acute or catastrophic events. The farther someone is from care, the more likely they are to forego standard care, resulting in expensive chronic conditions.
Safeguarding rural health facilities also maintains people’s dignity.
Picture an 80-year-old rural resident who needs to travel two and a half hours for a doctor’s visit because her familiar rural clinic closed its doors. What was once a short journey for care turns into a stress-provoking trek. It disrupts her routine and inconveniences those she relies on for help.
Ongoing Challenges
Rural providers often operate on extremely tight margins, which means every reimbursement payment is critical to keeping their doors open. At the same time, they grapple with manual processes, limited workflow systems, workforce shortages and a lack of automation.
Payers Can Be Catalysts for Change
Addressing rural health care inequities requires a multifaceted nationwide approach. Payers—both government and commercial—can contribute significantly to closing the gap by helping keep rural health facilities solvent.
Noridian Healthcare Solutions is a leading entity in this effort. The health care administrative services company is committed to minimizing rural providers’ administrative burden so they can maintain focus on delivering care and getting faster more accurate payments.
Noridian’s Contribution: Exceptional Provider Support
Noridian supports the largest network of rural providers, an outgrowth of its nearly 60 years administering Medicare which has since extended into other markets including Veteran’s Administration health care, commercial health plans and state Medicaid programs.
Their proactive provider management approach is a commitment to rural health center solvency. Noridian helps them establish efficient reimbursement practices which can otherwise be a challenge since rural providers often lack the resources to keep up with the diverse demands of various reimbursement systems.
Education
Education and outreach initiatives start with analyzing call trends and performance data, but their true effectiveness comes from a personalized one-on-one approach that meets providers where they are in their current understanding.
Providers, like Rex Walk, CEO of Memorial Hospital of Carbon County, value Noridian’s personalized instruction, acknowledging its role in enhancing their understanding of processes, boosting compliance, minimizing appeals and optimizing their business practices:
“Thank you all for your time, assistance and professionalism this past week. You all were so helpful and understanding. In addition, your team all made things so much easier. I experienced much ‘above and beyond’ efforts from all of you. I just wanted to say thank you and let you know how much I appreciated all your efforts. It was also a joy to talk with and communicate with all of you. Every interaction with each of you was such a positive, directional and insightful experience.”
Analysis
Noridian also invests in rural providers by continuously analyzing rural health trends, gaining a deeper understanding of their challenges and addressing them through refined solutions. It’s a company-wide affair, including Clinical Medical Directors (CMDs) who lead efforts to address health care inequities and disparities when developing Local Coverage Determinations (LCDs).
Geographic-Specific Reviews
Noridian develops its education and outreach strategy based on robust data analysis and a unique understanding of trends and risks in rural health care.
One recent example was concentrated in Wyoming and Montana. A geographic review raised some red flags around the use of surgical dressings in rural facilities. The Medical Review Team quickly intervened with an educational strategy that addressed improper payments.
Geographic reviews can also pinpoint educational opportunities to help decrease health disparities based on location or difficulty accessing services.
A Call To Collaborate
As the impact of rural health closures continues to grow, everyone across the health care spectrum can play a role in preserving access to care and bridging the health equity gap for rural Americans.
Noridian has found its contribution through exceptional provider service. To hear more or share ideas, contact their Provider Management Team today.
Rebecca Thompson is the Senior Capture Manager at Noridian Healthcare Solutions.
Sources
https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/
https://www.census.gov/library/stories/2017/08/rural-america.html