CEO Article: Independence

CEO Update: Independence

July is the month that our country celebrates its independence.  Colorado is one of those states that the people fled to, to enjoy owning land, having fresh air and I’m guessing, the chance to guide their own futures.   In Colorado we are lucky, most of our state remains rural with 47 of the 64 counties being designated as either rural or frontier. As our forefathers discovered and you can still enjoy, getting out to enjoy the land and the fresh air from mountains to plains is what makes this place special.  However, unfortunately, the rural way of life is being threatened as rural hospitals across the county are closing.  We know that when a rural hospital closes, the town suffers and often dies due to lack of jobs and healthcare.

Rural Hospitals and communities across the country are facing risk of closure, since 2010 87 have closed according to NRHA.  In Colorado, we have been lucky and have not had any rural hospitals close, even though 14 are operating in the red.  Recently the residents of Boulder with Anthem insurance faced an uncertain future in terms of where they would receive care if the hospital and insurance company could not come to terms of a contract agreement.   This is the uncertainty that many of our rural communities face daily.  If one of our 14 rural hospitals that are currently operating in the red were to close, people may have to travel up to two or three counties away to seek care.  Not just to seek hospital care, but potentially and likely to seek any type of care (including primary care).  This is unacceptable, it hits people when a big article comes out that impacts a large urban community, but people including policy makers seem to pay less attention when it’s our rural communities.  This is why CRHC takes our mission seriously and we work tirelessly to advocate and educate on the successes and barriers in rural health.

Rural health has an amazing amount of successes and is poised for innovation.  Critical Access Hospitals participating in CRHC’s iCARE Program have a 3% readmission rate, Rural Health Clinics participating have a 73% diabetes compliance rate and Community Paramedicine started in rural, with some of the experts from Eagle County.  Rural communities take care of one another and are some of the most giving people in the world.  Many of our rural hospitals host an annual fundraiser to help support the local hospital and clinic and even though community members maybe older, sicker and poorer, they find a way to give.  Policy makers, insurance companies, and those that create regulations, should find a way to give to rural communities as well.  For example, policy makers and those that create regulations could work together to reduce the number of regulations that are prohibiting true integration of care in rural communities, insurance companies should offer the same contract rates to rural communities as they do to urban and we should have a single insurance rate for Colorado, not one that is lower for people that live in wealthier counties and higher for those that live in rural.

Some of the barriers rural health faces is a limited ability to negotiate reimbursement with insurance companies, because of lack of competition.  With commercial insurance companies offering far less reimbursement to rural hospitals than they offer to urban hospitals, it exaggerates rural hospitals and clinics financial position.  Why you ask?  Because the majority of the population in rural communities are older, sicker and poorer, meaning that the percent of payer mix in rural is between 18% and 78% Medicare and Medicaid.  With these high percentages of Medicare and Medicaid, rural hospitals and clinics are at a disadvantage financially and then top that onto the fact that they receive less of a reimbursement from commercial insurance for payment, it’s a bad financial outlook.  When data on cost of services is released, that data doesn’t explain this complicated weave and doesn’t account for the fact that most physicians are employed by rural hospitals. These are an example of some of the barriers that we educate our policy makers on to help enact change.


If you want to lend your voice to helping make rural healthcare sustainable, reach out and join our Policy and Legislative Committee, reach out and help support change through funding and Sponsorship of the rural health center, speaking at our events, and/or partnership with us as we work towards a better future for rural health in Colorado.


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