News You Need to Know
Featured articles include… A Closer Look: Filling the Rural Provider Gap… Primary Physician Shortage Calls for Intervention…Translating Veterans’ Medical Skills into Nursing Careers… The Aging Workforce: Challenges for the Health Care Industry Workforce… Aging U.S. to Drive Up Heart-Related Health Costs: Study… Oregon’s Medicaid Lottery: A Participant’s View… Profile of Rural Health Clinics: Clinic & Medicare Patient Characteristics… Rural Areas See Increase in Immigrants

A Closer Look: Filling the Rural Provider Gap

May 2013
Meet Katja Austin: a wife, mother, volunteer and rural health care provider! Katja works at Middle Park Medical Center located in Kremmling, Colo. as a Family Nurse Practitioner. She practiced as a Registered Nurse for several years, but recently went back to school to further her education and earn an Advanced Practice Nurse degree. 
Her broader scope of practice as a nurse directly benefits the community by reducing patient wait time and enabling the clinic to serve more patients. Unfortunately though, it left Katja and her family with significant loan debt. Working at a rural facility with salaries averaging twenty to thirty percent less than their urban counterparts did not make the financial burden any easier for Katja. Looking for ways to ease her loan debt without having to leave Grand County, Katja applied for loan repayment from the Colorado Rural Outreach Program (CROP) and was awarded in June of 2011. Read the full story here.

Primary Physician Shortage Calls for Intervention
May 8, 2013
The American approach to primary health care is one of the more glaring failures of a dysfunctional health care system that costs almost twice as much per capita as that of any other major country — often with worse results.
Tragically, some 45,000 Americans die each year because they don’t see a doctor until it’s too late. Many others unnecessarily end up in hospitals at great cost and suffering because their illnesses were not diagnosed and treated at the appropriate time. Every day, tens of thousands of men, women and children who lack a primary care medical home flood emergency rooms across the country for nonemergency care at 10 times the cost of a visit to a primary-care facility.
Instituting major reforms in primary care and enabling people to see a doctor when they need one will save lives, ease suffering and save billions of dollars in wasteful health care costs. What should we do? Find out by clicking here.

Translating Veterans’ Medical Skills into Nursing Careers

April 29, 2013

Today, at the White House Forum on Military Credentialing and Licensing, Health and Human Services (HHS) Secretary Kathleen Sebelius announced a new program to help military veterans with health care experience or training, such as medics, pursue nursing careers. The program is designed to help veterans get bachelor’s degrees in nursing by building on their unique skills and abilities.

Administered by the Health Resources and Services Administration (HRSA) at HHS, the Veterans’ Bachelor of Science in Nursing Program will fund up to nine cooperative agreements, of up to $350,000 a year. Funding of $3 million is expected to be awarded by the end of fiscal year 2013 (September 30).
“The Veterans’ Bachelor of Science in Nursing Program recognizes the skills, experience and sacrifices of our veterans, while helping to grow our nursing workforce,” Secretary Sebelius said. “It helps veterans formalize their skills to get jobs, while strengthening Americans’ access to care.” Find out where program funding will go by clicking here

The Aging Workforce: Challenges for the Health Care Industry Workforce
March 2013

The aging of the U.S. population has tremendous implications for the health care industry, both as employers of an older workforce and as providers of services to a growing number of older patients. By 2050, the U.S. Census predicts that 19.6 million American workers will be 65 years or older, roughly 19 percent of the total U.S. workforce. In fact, the number of individuals in the labor force who are 65 years or older is expected to grow by 75 percent while the number of individuals in the workforce who are 25 to 54 is only expected to grow by 2 percent. By 2016, one-third of the total U.S. workforce will be 50 years or older — a group that may number 115 million by 2020 (Heidkamp, Mabe, & DeGraaf, 2012). Read the full article here.

Aging U.S. to Drive Up Heart-Related Health Costs: Study
April 24, 2013
The costs linked to heart failure in the United States are expected to more than double within the next two decades as the population ages and treatments help patients with the disease live longer, a study released on Wednesday found.
The American Heart Association predicted that the number of Americans with the fatal condition will grow to 8 million in 2030 from about 5 million in 2012. The costs to treat them will rise to $53 billion from $21 billion, the group said in its analysis.
If indirect costs related to heart failure are included, such as lost productivity and wages when patients become too sick to work, the total costs jump to $70 billion from $31 billion over the 18-year period, its study showed. Read the full article here to find out what the steep increase highlights.
Oregon’s Medicaid Lottery: A Participant’s View
May 10, 2013
study of Oregonians who won a 2008 state lottery to get Medicaid benefits has sparked an intense debate about the value of expanding health care to the poor and about the benefits of health insurance in general. The researchers reported in the New England Journal of Medicine last week that those who gained Medicaid coverage used more health services than low-income residents who had not been accepted into the program. But the Medicaid enrollees did not show significantly better blood pressure, cholesterol and blood sugar levels than the other group, although they had lower rates of depression.
After winning the lottery, Mary Carson, 55, was accepted into the Oregon Health Plan, the state’s Medicaid program, in 2011. She and her partner live with her three children. They earn about $1,000 a month by making and selling replicas of historic battle knives used in the Civil War and the two World Wars, doing odd jobs and providing respite care for people with cancer. Her comments on a popular blog about some of her own experiences on Medicaid have garnered some attention
Kaiser Health News interviewed Carson by phone this week. The following is an edited transcript of the interview.

Profile of Rural Health Clinics: Clinic & Medicare Patient Characteristics

March 2013
Review of 2009 Medicare Outpatient Claims Data
In 1977, Public Law 95-210 created the Rural Health Clinic (RHC) Medicare and Medicaid reimbursement designation for qualified primary care practices. With over 3,900 certified sites located across the county, RHCs are an important component of the rural health care infrastructure. RHCs can be private/for-profit or non-profit. Some operate as independent medical practices, while others are part of a hospital-owned system or other health care organization (“provider based”). RHCs receive cost-based reimbursement, subject to tests of reasonableness, for primary care services provided to Medicare beneficiaries. 

This Findings Brief is the second in a series on RHCs which draws on a large, national secondary dataset that includes data on all RHCs that bill Medicare. Using data extracted from 2009 Medicare outpatient provider claims, this Findings Brief presents a summary of the geographic distribution and clinic-level characteristics of RHCs, as well as an overview of the Medicare beneficiaries they served. Click here to read the study’s key findings.

Rural Areas See Increase in Immigrants
April 5, 2013
In key parts of rural America and ag-dependent metro counties, more than 25% of the population was born in a foreign country.
The percentage of the U.S. population born in foreign countries isn’t as great in rural areas as it in metro America. But the foreign-born population has been on the increase in non-metro areas, especially since 1990.
The Economic Research Service of the U.S. Department of Agriculture has followed this trend and has published a background report on “Immigration and the Rural Workforce.” Below are some key excerpts. You may find the entire report here.

Immigration Bill Aims to Ease Doctor Shortage

April 29, 2013
Sweeping reforms proposed to update U.S. immigration policy would include additional visa waivers for foreign physicians who agree to practice medicine in rural areas and other regions with underserved patient populations.
Organized medicine groups praised the Senate legislation, introduced on April 16, for aiming to improve international physicians’ and medical graduates’ ability to immigrate to and work in the U.S. The bill — the Border Security, Economic Opportunity, and Immigration Modernization Act — would strengthen the nation’s borders, provide new processes for individuals seeking to live legally in the country, and provide a potential way for some people in the country illegally to become American citizens, proponents said. Read the full article here.
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